Matthew Johnson, ATC
Specialist/Technologist, Athletic Trainer in Columbia, SC. Individual provider (NPI-1).
NPI number1164031050
StatusActive
Last updated in NPPESJul 27, 2020
Details
- NPI
- 1164031050
- Entity type
- Individual (NPI-1)
- Name
- Matthew Johnson
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 27, 2020
- Certification date
- Jul 27, 2020
- Last updated
- Jul 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2000038912 | NC | Yes |
Practice location
1300 Wheat StColumbia, SC 29208-0001
Phone 919-356-7356
Mailing address
3109 Jefferson Davis HwySanford, NC 27332-7117
Phone 919-356-7356
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