Individual
MATTHEW LEE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSAT, ATC, LAT
Contact information
Practice address
30461 GARNAND DR, EMORY, VA 24327
(276) 944-6835
(276) 944-6738
Mailing address
30461 GARNAND DR, EMORY, VA 24327-2500
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126004153
VA
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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