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1013228295
WILLIAM BLAKE MATLOCK
BEND, OR
NPI
1013228295
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 4366)
Enumeration Date
2010-06-23
Last Update Date
2016-04-14
Business Address
WILLIAM BLAKE MATLOCK MSPT
1693 SW CHANDLER AVE SUITE 140
BEND, OR 97702-3236
Phone number: 541-390-0523
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Mailing Address
WILLIAM BLAKE MATLOCK MSPT
PO BOX 72
BEND, OR 97709-0072
Phone number: 541-390-0523
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