Individual
NICHOLE MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 OAK ST, BALDWIN, WI 54002
(715) 222-2837
Mailing address
1180 OAK ST, BALDWIN, WI 54002
(715) 222-2837
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
405708
MN
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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