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NPI Code Detail

MEDICARE: MATTHEW VOSS ATC

MEDICARE: MATTHEW VOSS ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer2363MN

General Provider Information

NPI Number : 1790184877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW VOSS ATC
Provider Business Mailing Address
First Line : 4010 W 65TH ST
Second Line :
City : EDINA
State : MN
Zip : 55435-1706
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4010 W 65TH ST
Second Line :
City : EDINA
State : MN
Zip : 55435-1706
Country : US
Telephone Number : 952-920-0970
Fax Number : 952-920-0148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2014
Last Update Date : 08/14/2014

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