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Organization

GEORGIA SOUTHERN UNIVERSITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW MASSAR (AUTHORIZED OFFICIAL)
(847) 250-5470
Entity
Organization

Contact information

Practice address
HANNER FIELD HOUSE, 590 HERTY DRIVE ROOM 1216C, STATESBORO, GA 30460-1000
(912) 531-1436
(912) 478-1017
Mailing address
PO BOX 8082, STATESBORO, GA 30460-1000

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
09/17/2025
Last updated
09/17/2025
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