Individual
TYLER AUSTIN MATTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3280 MITCHELL BLVD, MOODY AFB, GA 31699-9402
(520) 861-6058
Mailing address
8246 KNIGHTS WAY, MOODY AFB, GA 31699-1800
(229) 257-2778
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/21/2022
Last updated
10/05/2023
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