Individual
JARRETT THOMAS MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
190 SHADOWMEADE LN, MOUNT WASHINGTON, KY 40047-6277
(502) 538-2332
Mailing address
214 N MAIN ST, NEW HAVEN, KY 40051-6343
(502) 827-3347
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A04536
KY
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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