Individual
MR. JOHN DAVID MATZOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1350 GARDENA AVE NE, FRIDLEY, MN 55432-5830
(763) 571-9116
(763) 571-9118
Mailing address
1350 GARDENA AVE NE, FRIDLEY, MN 55432-5830
(763) 571-9116
(763) 571-9118
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1204
MN
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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