Individual
MASON THOMAS MATZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2501 KENTUCKY AVE, PADUCAH, KY 42003-3813
(270) 575-2100
Mailing address
624 DERBY CIR, PADUCAH, KY 42003-1264
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3018186
KY
Other
Enumeration date
07/21/2022
Last updated
10/12/2022
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