Individual
DR. PATRIC WILLIAM MATTEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
970 S SILVER LAKE ST STE 102, OCONOMOWOC, WI 53066-3802
(262) 569-7100
(262) 567-6295
Mailing address
W206S7867 PASADENA DR, MUSKEGO, WI 53150-9532
(262) 971-5015
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2508-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40938300
—
WI
Enumeration date
10/05/2005
Last updated
04/11/2023
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