NPI 1366645558

Matthew Weisenberger, ATC

Practitioner Athletic Trainer Tupelo, MS

Practice location

Address: 4381 S Eason Blvd, Tupelo, MS 38801-6583
Phone: (662) 377-7215
Mailing address: 124 County Road 131, Tupelo, MS 38804

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT 0143 (MS)

Other Specialist/Technologist providers in Mississippi →

Registry record

NPI: 1366645558
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jun 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.