Individual
MR. MATTHEW WAYNE HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3047 WILLIAM ST, CAPE GIRARDEAU, MO 63703-6393
(573) 339-5989
(573) 339-7092
Mailing address
509 KEELEY AVE, SCOTT CITY, MO 63780-1631
(573) 264-3632
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
113907
MO
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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