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General NPI Number Information
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NPI Number | 1336250315
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Entity Type | Organization
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Legal Business Name | MATTHEW J PIERZALA DO PSC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6572 MIDLAND TRAIL RD
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City | ASHLAND
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State | KY
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Zip | 41102-9286
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Country | US
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Telephone | 606-928-7755
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Fax | 606-928-0052
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Provider Business Mailing Address
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Address Line | 6572 MIDLAND TRAIL RD
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City | ASHLAND
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State | KY
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Zip | 41102-9286
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Country | US
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Telephone | 606-928-7755
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Fax | 606-928-0052
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LORI K MILLER
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Credential |
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Telephone | 606-928-7755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | KY02941
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License Number State | KY
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