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Individual

MATTHEW HERRICK CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
516 15TH AVE SE, MINNEAPOLIS, MN 55455-0130
(612) 625-6864
(612) 626-4789
Mailing address
516 15TH AVE SE, MINNEAPOLIS, MN 55455-0130
(612) 625-6864
(612) 626-4789

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
02/28/2012
Last updated
02/28/2012
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