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1841031036
MATTHEW LEAGUE
LOUISVILLE, KY
NPI
1841031036
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-06-03
Last Update Date
2024-06-03
Business Address
MATTHEW LEAGUE DO
550 S JACKSON ST
LOUISVILLE, KY 40202-1622
Phone number: 909-287-4397
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Mailing Address
MATTHEW LEAGUE DO
10922 LEANING ASH LN
HOUSTON, TX 77079-3614
Phone number: 909-287-4397
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