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1235598392
DESIREE ANN MATA
GRANTS PASS, OR
NPI
1235598392
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 06567)
Enumeration Date
2016-02-17
Last Update Date
2016-02-17
Business Address
Ms. DESIREE ANN MATA PT
1710 NE FAIRVIEW AVE
GRANTS PASS, OR 97526-3877
Phone number: 541-479-2606
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Mailing Address
Ms. DESIREE ANN MATA PT
406 NE SILVERWOOD PL
GRANTS PASS, OR 97526-2226
Phone number: 541-450-2496
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