Individual
MATTHEW BRANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
4930 STARBOARD CIR APT 108, MECHANICSBURG, PA 17050-3242
(850) 419-1400
Mailing address
4930 STARBOARD CIR APT 108, MECHANICSBURG, PA 17050-3242
(850) 419-1400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007123
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000033950
BOC
—
01
—
RT007123
LICENSE
PA
Enumeration date
01/11/2021
Last updated
01/11/2021
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