Individual
JON R MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
661 13TH AVE, PROSPECT PARK, PA 19076-1202
(610) 657-2294
Mailing address
661 13TH AVE, PROSPECT PARK, PA 19076-1202
(610) 657-2294
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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