MICHAEL LEROY MATTESON

CARBONDALE, IL
NPI1033386115
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: IL  385000710)
Enumeration Date2008-05-08
Last Update Date2011-10-13
Business Address
Mr. MICHAEL LEROY MATTESON PA C
305 W JACKSON ST SUITE 105
CARBONDALE, IL 62901-1474
Phone number: 618-536-2565
Mailing Address
Mr. MICHAEL LEROY MATTESON PA C
PO BOX 1105
INDIANAPOLIS, IN 46206-1105
Phone number: 618-457-5200
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