Individual
MATT DE GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
122 EDGEWOOD DR, BRODHEADSVILLE, PA 18322-7787
(570) 807-1607
Mailing address
122 EDGEWOOD DR, BRODHEADSVILLE, PA 18322-7787
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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