MATTHEW JAMES REVENNAUGH

RICHMOND, IN
NPI1619562386
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IN  10003154A)
Enumeration Date2021-03-04
Last Update Date2021-09-22
Business Address
MATTHEW JAMES REVENNAUGH PA
1400 HIGHLAND RD STE 1
RICHMOND, IN 47374-8810
Phone number: 765-935-8905
Mailing Address
MATTHEW JAMES REVENNAUGH PA
1100 REID PARKWAY MEDICAL STAFF SERVICES
RICHMOND, IN 47374
Phone number: 659-358-8027