NPI 1437650181

Matthew Leeds, MSATCLATCMP

Practitioner Athletic Trainer Ellington, CT

Practice location

Address: 12 Main St STE 7, Ellington, CT 06029-3361
Phone: (860) 872-7500
Mailing address: 51 Meadow Brook Rd APT 91, Ellington, CT 06029-2230

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 000801 (CT)

Other Specialist/Technologist providers in Connecticut →

Registry record

NPI: 1437650181
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Feb 2018
Record last updated: 27 Feb 2018

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.