Individual
BRENNAN MICHAEL MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-8613
Mailing address
6421 W KRISTAL WAY, GLENDALE, AZ 85308-7130
(509) 675-2787
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
1710I1003X
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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