Individual
KATHLEEN MARY MATTOCKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2612 E 32ND ST, ERIE, PA 16510-2706
(814) 899-1095
Mailing address
2612 E 32ND ST, ERIE, PA 16510-2706
(814) 899-1095
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN153140L
PA
Other
Enumeration date
10/04/2011
Last updated
10/04/2011
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