Individual
MR. TERRY VERNON MATULLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-A
Contact information
Practice address
20 S MAIN ST STE 14, JANESVILLE, WI 53545-3959
(608) 752-3529
(608) 752-3529
Mailing address
20 S MAIN ST STE 14, JANESVILLE, WI 53545-3959
(608) 752-3529
(608) 752-3529
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
189156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41110400
—
WI
Enumeration date
09/13/2007
Last updated
09/13/2007
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