Individual
PAYNE MATTHIESEN ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
114 CENTER RD, DUDLEY, MA 01571-6310
(508) 213-2240
Mailing address
114 CENTER RD, DUDLEY, MA 01571-6310
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3089
MA
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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