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1841763992
MATTHEW SIMON WINSLOW
FORT BRAGG, CA
NPI
1841763992
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X Community/Behavioral Health
(Licence: CA MFC41677)
Enumeration Date
2019-01-10
Last Update Date
2019-01-10
Business Address
MATTHEW SIMON WINSLOW
137 E OAK ST
FORT BRAGG, CA 95437-3610
Phone number: 707-345-4012
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Mailing Address
MATTHEW SIMON WINSLOW
101 N FRANKLIN ST
FORT BRAGG, CA 95437-3602
Phone number: 707-961-0172
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