Individual
MR. MALCOLM RAY MATZDORFF JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
612 E DIXIE AVE, ELIZABETHTOWN, KY 42701-1077
(270) 982-7378
Mailing address
612 E DIXIE AVE, ELIZABETHTOWN, KY 42701-1077
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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