Individual
BILLIE JO MATTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
420 PACIFIC AVE, MOTT, ND 58646-7515
(701) 824-2391
Mailing address
1000 HIGHWAY 12, HETTINGER, ND 58639-7530
(701) 567-4561
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0427
ND
Other
Enumeration date
07/15/2010
Last updated
07/02/2013
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