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Organization
GEORGIA SOUTHERN UNIVERSITY
Active
Organization
GEORGIA SOUTHERN UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MASAR (AUTHORIZED OFFICIAL)
(847) 250-5470
Entity
Organization
Contact information
Practice address
TED SMITH FAMILY FOOTBALL CENTER, 205 LANIER DRIVE, STATESBORO, GA 30458-1524
(912) 478-5509
Mailing address
205 LANIER DR, STATESBORO, GA 30458-1524
(912) 478-5509
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/12/2026
Last updated
03/12/2026
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