Individual
MR. MATTHEW TIMOTHY YATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2500 RIVERMONT AVE, LYNCHBURG, VA 24503-1555
(434) 947-8356
Mailing address
2500 RIVERMONT AVE, LYNCHBURG, VA 24503-1555
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002215
VA
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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