Individual
MATTHEW KYLE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
32 E MAIN ST, MARSHALLTOWN, IA 50158-4903
(641) 753-6636
Mailing address
2612 RIDGE RD, MARSHALLTOWN, IA 50158-9549
(641) 691-6286
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001097
IA
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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