Individual
MATTHEW ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12536 S HAGAN LN, OLATHE, KS 66062-6074
(913) 484-3058
Mailing address
4455 N 1ST ST APT 195, LINCOLN, NE 68521-4825
(913) 484-3058
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
07/27/2021
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