Individual
NATHAN D MATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2850 OLYMPUS DR, POCATELLO, ID 83201-2271
(208) 239-2273
Mailing address
1630 PETERSBURG DR, CHUBBUCK, ID 83202-5271
(208) 970-1892
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/04/2021
Last updated
01/16/2024
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