Delores Genevieve Matz, LCMT

NPI #1215104211 in Elk River, Minnesota

Provider Information

NPI Number: 1215104211
Entity Type: Individual
Name: Delores Genevieve Matz, LCMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Credential: LCMT
Enumeration Date: May 9, 2008
Last Updated: May 9, 2008

Practice Location

Address: 200 5TH ST NW
Address 2: SUITE D
City: Elk River
State: Minnesota
ZIP Code: 55330-1917
Phone: (763) 300-1022

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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