Individual
PROF. MATTHEW JO GAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LAT, ATC
Contact information
Practice address
1971 UNIVERSITY BLVD, LYNCHBURG, VA 24515-1903
(434) 592-3763
(434) 582-7261
Mailing address
3552 BRIDLEWOOD LN, TERRE HAUTE, IN 47802-9269
(812) 237-3961
(812) 237-3615
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002093
VA
Other
Enumeration date
11/02/2011
Last updated
07/23/2020
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