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1962105833
JONATHAN ROBERT MATTINGLY
LOUISVILLE, KY
NPI
1962105833
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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
2023-03-22
Last Update Date
2023-03-22
Business Address
JONATHAN ROBERT MATTINGLY
500 S PRESTON ST
LOUISVILLE, KY 40202-1702
Phone number: 502-852-5193
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Mailing Address
JONATHAN ROBERT MATTINGLY
7805 BINFORD WAY
LOUISVILLE, KY 40291-5279
Phone number: 502-489-4641
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