Individual
WILSON MATTHEW MCKNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1164 MAIN STREET, VILONIA, AR 72173-7217
(501) 472-4442
(501) 472-4442
Mailing address
14 KIMBERLY DRIVE, VILONIA, AR 72173
(501) 472-4442
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
677
AR
Other
Enumeration date
05/14/2017
Last updated
03/17/2018
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