Individual
ADAM MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12169 COOK RD, GAINES, MI 48436-9617
(810) 610-7732
Mailing address
12169 COOK RD, GAINES, MI 48436-9617
(810) 610-7732
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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