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Individual

KYLE MATTHEWSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
100 W COLLEGE ST, GRANVILLE, OH 43023-1100
(740) 587-8641
Mailing address
612 ESSEN PL, WESTERVILLE, OH 43081-3457
(740) 590-2916

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
AT002638
GA
2255A2300X
Athletic Trainer
Primary
AT004566
OH

Other

Enumeration date
05/25/2016
Last updated
03/17/2018
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