Organization
MAT VENTURES LLC
Active
Organization
MAT VENTURES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY MARKISICH (OWNER)
(801) 558-6564
Entity
Organization
Contact information
Practice address
8388 S WASATCH BLVD, COTTONWOOD HEIGHTS, UT 84121-6075
(801) 558-6564
Mailing address
PO BOX 639, DRAPER, UT 84020-0601
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
12/17/2020
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