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1033465307
TYLER ANDREW MATLOCK
FAIRBANKS, AK
NPI
1033465307
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-07-24
Last Update Date
2012-07-24
Business Address
Mr. TYLER ANDREW MATLOCK
3830 S CUSHMAN ST
FAIRBANKS, AK 99701-7530
Phone number: 907-455-5304
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Mailing Address
Mr. TYLER ANDREW MATLOCK
3830 S CUSHMAN ST
FAIRBANKS, AK 99701-7530
Phone number: 907-455-5304
Copy
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