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1003236506
AUSTIN MATLOCK
JEFFERSON CITY, MO
NPI
1003236506
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2011025934)
Enumeration Date
2014-04-23
Last Update Date
2014-04-23
Business Address
Mr. AUSTIN MATLOCK ATC
820 CHESTNUT ST 115 JASON HALL
JEFFERSON CITY, MO 65101-3537
Phone number: 573-681-5331
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Mailing Address
Mr. AUSTIN MATLOCK ATC
2609A SOUTHRIDGE DR
JEFFERSON CITY, MO 65109-2069
Phone number:
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