Individual
MATTHEW LEEDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT, CMP
Contact information
Practice address
12 MAIN ST STE 7, ELLINGTON, CT 06029-3361
(860) 872-7500
Mailing address
51 MEADOW BROOK RD APT 91, ELLINGTON, CT 06029-2230
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000801
CT
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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