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Individual
MATTHEW ROBERT WHITESELL
Active
Individual
MATTHEW ROBERT WHITESELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSA, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0000001156
TN
2255A2300X
Athletic Trainer
Primary
096002069
IL
Other
Enumeration date
12/12/2007
Last updated
12/10/2015
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