Individual
MR. JOHN WILEY MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3400 LEBANON RD, MURFREESBORO, TN 37129-1237
(615) 893-1360
(000) 000-0000
Mailing address
2310 RIVERSTONE DR, MURFREESBORO, TN 37128-6725
(615) 893-1360
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
023
TN
Other
Enumeration date
07/31/2006
Last updated
07/09/2007
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