Individual
JUSTIN MICHAEL MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
3705 MONROE RD, DE PERE, WI 54115-4020
(920) 336-6096
Mailing address
3705 MONROE RD, DE PERE, WI 54115-4020
(920) 336-6096
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17629-40
WI
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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