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MR. MATTHEW RYAN HORTON ATC, VATL

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1427393735

Individual Registrant:
MR. MATTHEW RYAN HORTON ATC, VATL
Gender: M
Sole Proprietor

Location and contact information for practice:
3650 JOSEPH SIEWICK DR STE 400  FAIRFAX, VA 22033-1715 US
Tel: 571-201-6484  Fax: --

Contact information for business:
9421 WILLIAM KIRK LN  BURKE, VA 22015-4252 US
Tel: --  Fax: --

Registration Information:
NPI: 1427393735
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
VA0126001048

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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