Individual
MATTHEW J JALAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
BLANCHFIELLD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, FT. CAMPBELL, KY 42223-5349
(270) 798-8372
(270) 956-0180
Mailing address
BLANCHFIELLD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, FT. CAMPBELL, KY 42223-5349
(270) 798-8372
(270) 956-0180
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1305
AL
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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