Individual
MATTHEW WAYNE ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
2301 E ARDEN DR, BLOOMINGTON, IN 47401-6890
(812) 361-9947
Mailing address
2301 E ARDEN DR, BLOOMINGTON, IN 47401-6890
(812) 361-9947
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003265A
IN
Other
Enumeration date
06/11/2019
Last updated
09/05/2019
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