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General NPI Number Information
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NPI Number | 1215560982
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Entity Type | Individual
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Provider Name | MATTHEW GRAEME PATERSON REID CMT, CES
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Gender | Male
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 5203 YOUNG ST
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9833
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Country | US
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Telephone | 661-342-5876
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 S HALF MOON DR APT B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-7874
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Country | US
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Telephone | 661-342-5876
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1180177192
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License Number State | CA
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