Individual
MATTHEW JOHN LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., A.T., A.T.C.
Contact information
Practice address
475 W SPARTAN DR, SPARTA, MI 49345-8734
(616) 581-5296
Mailing address
4100 LAKE DR SE, SUITE 300, GRAND RAPIDS, MI 49546-8292
(616) 581-5296
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001300
MI
Other
Enumeration date
06/24/2014
Last updated
12/10/2015
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