Individual
MATTHEW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1300 WHEAT ST, COLUMBIA, SC 29208-0001
(919) 356-7356
Mailing address
3109 JEFFERSON DAVIS HWY, SANFORD, NC 27332-7117
(919) 356-7356
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000038912
NC
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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