Individual
KENNETH MATTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.C.P.
Contact information
Practice address
1764 SCARLETT AVE, NORTH PORT, FL 34289-9476
(941) 456-1121
Mailing address
1764 SCARLETT AVE, NORTH PORT, FL 34289-9476
(941) 456-1121
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
—
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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