Individual
MATTHEW KIRK GARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 353-2465
Mailing address
1714 LIONS CAMP RD, ANACOCO, LA 71403-3215
(417) 983-8456
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
51282
HI
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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