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General NPI Number Information
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NPI Number | 1588603831
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Entity Type | Individual
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Provider Name | MATTHEW RYAN COOK A.T.C., L.A.T.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 04/06/2009
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Provider Practice Location Address
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Address Line | AMHERST COLLEGE ALUMNI GYM 2230
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City | AMHERST
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State | MA
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Zip | 01002
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Country | US
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Telephone | 413-542-5303
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Fax | 413-542-8187
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Provider Business Mailing Address
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Address Line | 1491 S EAST ST
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City | AMHERST
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State | MA
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Zip | 01002-3031
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Country | US
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Telephone | 508-479-6450
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Fax | 413-542-8187
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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 | 1671
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License Number State | MA
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