Individual
GWEN D. MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
300 E 15TH ST, MERCED, CA 95341-6217
(209) 381-6819
(209) 381-6871
Mailing address
P O BOX 2087, MERCED, CA 95341-6217
(209) 381-6819
(209) 381-6871
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
236591
CA
Other
Enumeration date
06/02/2011
Last updated
01/27/2016
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