Individual
MATTHEW LEE MALLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, ATC, OTC
Contact information
Practice address
2805 CAMPUS DR STE 465, PLYMOUTH, MN 55441-2680
(952) 946-9777
(952) 946-9888
Mailing address
8100 W 78TH ST STE 230, EDINA, MN 55439-2570
(952) 946-9777
(952) 946-9888
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000027256
MN
Other
Enumeration date
01/08/2017
Last updated
04/19/2022
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