Thor Mataya, CPOA
NPI #1700240470 in Trevose, Pennsylvania
Provider Information
- NPI Number
- 1700240470
- Entity Type
- Individual
- Name
- Thor Mataya, CPOA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist, Other
- Credential
- CPOA
- Enumeration Date
- Apr 8, 2016
- Last Updated
- Apr 8, 2016
Practice Location
- Address
- 2612 LINCONIA AVE
- City
- Trevose
- State
- Pennsylvania
- ZIP Code
- 19053-6736
- Phone
- (267) 980-7415
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other |
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