Individual
MR. MATTHEW JAMES HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1700 W STOUT ST, RICE LAKE, WI 54868-5000
(715) 236-8100
Mailing address
3980 S 18TH ST, SHEBOYGAN, WI 53081-7564
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1565
WI
Other
Enumeration date
01/17/2014
Last updated
02/07/2014
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