Individual
AMANDA NICOLE MATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1345 HENDERSONVILLE RD, ASHEVILLE, NC 28803-1923
(828) 274-0757
Mailing address
415 CHUNNS COVE RD APT 100B, ASHEVILLE, NC 28805-1034
(305) 321-0760
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3180
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3180
LAT
NC
Enumeration date
07/25/2017
Last updated
07/25/2017
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