Provider Demographics
NPI:1871702886
Name:KIRKPATRICK, MATTHEW J (ATC, MAE)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:KIRKPATRICK
Suffix:
Gender:M
Credentials:ATC, MAE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6247 RUSSET LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4633
Mailing Address - Country:US
Mailing Address - Phone:205-426-0982
Mailing Address - Fax:
Practice Address - Street 1:806 SAINT VINCENTS DR
Practice Address - Street 2:WCC STE. 620
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1684
Practice Address - Country:US
Practice Address - Phone:205-933-1557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer