Individual
MATTHEW CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
505 JIM CALHOUN WAY, STORRS, CT 06268-1728
(860) 208-3490
Mailing address
505 JIM CALHOUN WAY, STORRS, CT 06268-1728
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1406
CT
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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