Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MATTHEW EDWIN WALLACE, ATC, PES
ActiveMR. MATTHEW EDWIN WALLACE, ATC, PES is a Athletic Trainer healthcare provider located in OMAHA, Nebraska. NPI 1760426258 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · OMAHA, NE
Registration Details
- NPI Number
- 1760426258
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 15, 2006 (20.13844674213 yrs)
- Last Updated
- Jul 8, 2007
- License
-
378 (NE)
Practice Information
- Address
-
CREIGHTON UNIUVERSITY2500 CALIFORNIA PLAZAOMAHA, NE, 681780001Browse NE providers · Browse ZIP 68178
- Phone
- 4022805563
- Fax
- 4022803110
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in OMAHA, NE
| Name | Credential | NPI |
|---|---|---|
| MICHAEL ELVIN ROBERTS | ATC | 1528047156 |
| MR. THOMAS ALLAN FRETTE | ATC | 1649243825 |
| MR. STEVEN C BRACE | ATC | 1356315204 |
| DENISE FANDEL | AT RET. | 1588632293 |
| MR. KEVIN LEROY DEREMER | ATC | 1679535413 |
| MR. AARON T SPENCER | RN, ATC | 1730142787 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.