Individual
MATTHEW HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1074 E WATERCRESS LN, APT. 4Q, MIDVALE, UT 84047-5044
(865) 599-6470
Mailing address
1074 E WATERCRESS LN, APT. 4Q, MIDVALE, UT 84047-5044
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/19/2014
Last updated
12/19/2014
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