Individual
MATTHEW WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT IASI
Contact information
Practice address
369 NE REVERE AVE, SUITE B, BEND, OR 97701-4059
(541) 848-9271
Mailing address
19434 SW HOLLYGRAPE ST, BEND, OR 97702-2876
(541) 846-9271
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13145
OR
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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