Individual
MR. MATTHEW TYLER HAZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
600 MANOR DR, CLARINDA, IA 51632-2444
(712) 542-5164
Mailing address
600 MANOR DR, CLARINDA, IA 51632-2444
(712) 542-5164
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2004029638
MO
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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