Individual
MR. THOMAS ANTHONE TAYLOR MATROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
710 19TH AVE N STE 300, SOUTH ST PAUL, MN 55075-1301
(651) 471-9038
Mailing address
710 19TH AVE N STE 300, SOUTH ST PAUL, MN 55075-1301
(651) 471-9038
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L730901
MN
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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