Individual
TRAVIS MOAKLEY MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 E LANCASTER AVE STE 467, WYNNEWOOD, PA 19096-3434
(610) 896-0210
(610) 896-5101
Mailing address
100 E LANCASTER AVE STE 467, WYNNEWOOD, PA 19096-3434
(610) 896-0210
(610) 896-5101
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
OS022855
PA
Other
Enumeration date
06/19/2018
Last updated
05/08/2024
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