Individual
MATTHEW RYAN BLOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1300 OLD PLANK RD, MAYFIELD, PA 18433-1973
(570) 281-6222
Mailing address
238 SPRING MOUNTAIN DR, ZION GROVE, PA 17985-9313
(570) 590-8765
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW137522
PA
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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