MATTHEW MARK JOHNSON

MESA, AZ
NPI1770556128
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: AZ  0338)
Additional Taxonomies2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ID  AT-214)
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date2006-02-08
Last Update Date2007-07-08
Business Address
MATTHEW MARK JOHNSON MS, ATC, CSCS
160 E 6TH PL FITCH PARK
MESA, AZ 85201-5068
Phone number: 480-668-4565
Mailing Address
MATTHEW MARK JOHNSON MS, ATC, CSCS
442 N KENSINGTON AVE
LA GRANGE PARK, IL 60526-1872
Phone number: 617-680-1863
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