Provider Demographics
NPI:1811277544
Name:FLISS, MATTHEW PAUL (ELECTO-TOXICOLOGIST)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PAUL
Last Name:FLISS
Suffix:
Gender:M
Credentials:ELECTO-TOXICOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 HIGHWAY 61
Mailing Address - Street 2:
Mailing Address - City:GOODVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55987-1659
Mailing Address - Country:US
Mailing Address - Phone:507-410-1144
Mailing Address - Fax:
Practice Address - Street 1:4465 HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:GOODVIEW
Practice Address - State:MN
Practice Address - Zip Code:55987-1659
Practice Address - Country:US
Practice Address - Phone:507-410-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist