DEREK LOGAN MATTINGLY

RIVERVIEW, FL
NPI1245883677
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2019-07-24
Last Update Date2019-07-24
Business Address
DEREK LOGAN MATTINGLY
6221 WATERMARK DR APT 106
RIVERVIEW, FL 33578-3975
Phone number: 859-457-9190
Mailing Address
DEREK LOGAN MATTINGLY
6221 WATERMARK DR APT 106
RIVERVIEW, FL 33578-3975
Phone number: 859-457-9190
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