Individual
MATTIE KNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 WENTWORTH DR, MONTGOMERY, AL 36106-3239
(334) 419-7312
Mailing address
2400 WENTWORTH DR, MONTGOMERY, AL 36106-3239
(334) 419-7312
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
201805057
AL
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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