Individual
MATTHEW BRYAN WANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
122 OAK VIEW CIR, PONTE VEDRA BEACH, FL 32082-2645
(412) 999-2922
Mailing address
5 LONGVIEW DR, AVELLA, PA 15312-2756
(412) 999-2922
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
09/21/2019
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