Doctor Name: | KELLY J MATTHEWS |
NPI Number: | 1528256583 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S. |
License Number: | 0788 |
Business Practice Address: | 13055 W Mcdowell Rd. Suite G-107 Avondale, AZ - 85323 |
Business Phone Number: | 6236409819 |
Business Fax Number: | |
Mailing Address: | 16908 W Weymouth Rd, SURPRISE |
State: | AZ |
Postal Code: | 853740840 |
Phone Number: | 6236409819 |
Fax Number: | |
NPI Enumeration Date: | 10/04/2007 |
NPI Last Update Date: | 10/04/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0788 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |