Individual
MATT SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 20TH ST # 80639, GREELEY, CO 80639-6900
(197) 035-1189
Mailing address
2840 W 21ST ST UNIT 10, GREELEY, CO 80634-6651
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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