MEDICARE: TORI NICOLE MATTESON CPHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183700000X	Pharmacy Technician

General Provider Information

NPI Number	:	1174465462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORI NICOLE MATTESON CPHT

Provider Business Mailing Address
First Line	:	1413 EASY ST
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-6934
Country	:	US
Telephone Number	:	406-559-7167
Fax Number	:

Provider Business Practice Location Address
First Line	:	1413 EASY ST
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-6934
Country	:	US
Telephone Number	:	406-559-7167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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