Individual
KENNETH J MATTEONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 E WILLIAMS AVE, FALLON, NV 89406-3052
(775) 867-7740
(775) 423-8871
Mailing address
801 E WILLIAMS AVE, FALLON, NV 89406-3052
(775) 867-7757
(775) 423-8871
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
9079
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016746
—
NV
Enumeration date
01/10/2006
Last updated
01/06/2021
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