Individual
AMANDA MARIE MATTINGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 HANNAH BLVD STE 216, EAST LANSING, MI 48823
(517) 364-8100
Mailing address
2900 HANNAH BLVD STE 216, EAST LANSING, MI 48823-5382
(517) 364-8100
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601009055
MI
Other
Enumeration date
03/23/2018
Last updated
09/15/2022
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