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Individual

MATTHEW KINGSBURY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
379 FIELD HOUSE DR, COLLEGE PARK, MD 20742-0001
(240) 417-1611
Mailing address
3817 MYSTIC COVE CT, VIRGINIA BEACH, VA 23455-2913

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
MD

Other

Enumeration date
08/12/2012
Last updated
08/12/2012
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