Individual
MATTHEW MEWBOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 RIVER RD, ATHENS, GA 30605
(404) 368-7644
Mailing address
175 HARDIN DR, ATHENS, GA 30605-1519
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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