MATTHEW NIESEN

JACKSONVILLE, FL
NPI1508256744
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: HI  224)
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL  AL4715)
Enumeration Date2015-01-26
Last Update Date2020-01-29
Business Address
MATTHEW NIESEN ATC
7000 POWERS AVE
JACKSONVILLE, FL 32217-3318
Phone number: 904-708-7919
Mailing Address
MATTHEW NIESEN ATC
13494 SUNSTONE ST
JACKSONVILLE, FL 32258-5479
Phone number: 904-708-7919
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