Individual
SHAWN MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 745-4451
Mailing address
1000 E MAIN ST, DANVILLE, IN 46122-1948
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002134A
IN
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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