Matthew Armistead, LAT, ATC

Individual provider Active NPI Athletic Trainer · University Park, PA

NPI 1124553649 · NPPES record last updated Sep 1, 2020

Key facts

NPI
1124553649
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT006518 (PA)
Practice address
147 Recreation Hall
University Park, PA 16802-5701
Phone
(302) 757-2624
NPI assigned
Apr 21, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RT006518PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT006518 PA Yes

Addresses

Primary practice location

147 Recreation Hall
University Park, PA 16802-5701

Mailing address

165 Meadow LN
Bellefonte, PA 16823-7633

Electronic endpoints

TypeEndpointUseAffiliation
Other URL https://blueocean.edh.com/

Other providers in University Park, PA

All providers in University Park, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.