JONATHAN LEE MATTINGLY

MARION, IL
NPI1154057404
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: IL  043.118516)
Enumeration Date2022-07-28
Last Update Date2022-08-04
Business Address
Mr. JONATHAN LEE MATTINGLY LPN
11531 SUNDERLAND RD # A
MARION, IL 62959-8274
Phone number: 618-534-3624
Mailing Address
Mr. JONATHAN LEE MATTINGLY LPN
11531 SUNDERLAND RD
MARION, IL 62959-8274
Phone number: 618-964-5139
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