Matthew Jackson, M.S., ATC, LAT

Individual provider Active NPI Athletic Trainer · Townsend, MA

NPI 1306237201 · NPPES record last updated Feb 12, 2015

Key facts

NPI
1306237201
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2701 (MA)
Practice address
51 Edward Rd
Townsend, MA 01469-1107
Phone
(978) 732-3293
NPI assigned
Feb 12, 2015
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2701MAMDGeriatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2701 MA Yes

Addresses

Primary practice location

51 Edward Rd
Townsend, MA 01469-1107

Mailing address

51 Edward Rd
Townsend, MA 01469-1107
Phone (978) 732-3293

Other providers in Townsend, MA

All providers in Townsend, MA · Athletic Trainer in Massachusetts

Sources for this page

Verify at the official NPI Registry.