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Individual

MATTHEW MANSFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
286 HIGHWAY VV, BROSELEY, MO 63932-9174
(573) 686-4877
Mailing address
286 HIGHWAY VV, BROSELEY, MO 63932-9174
(573) 686-4877

Taxonomy

Speciality
Code
Description
License number
State
174V00000X
Clinical Ethicist
372600000X
Adult Companion
Primary
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant

Other

Enumeration date
08/01/2014
Last updated
08/01/2014
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