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Individual

DR. CHANCE LEE MATTHIESEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
932 E 34TH ST, JOPLIN, MO 64804-3932
(417) 347-2200
(417) 347-2204
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-2200
(417) 347-2204

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2016036874
MO
2085R0001X
Radiation Oncology Physician
25819
OK

Other

Enumeration date
08/06/2007
Last updated
11/16/2016
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