Individual
DR. MATTHEW LUTES MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
223 DELAINA DR, SUITE B, MT WASHINGTON, KY 40047-7148
(502) 593-7894
Mailing address
PO BOX 691, MT WASHINGTON, KY 40047-0691
(502) 593-7894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1714DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100018320
—
KY
Enumeration date
07/17/2007
Last updated
06/16/2008
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