MEDICARE: MR. MATTHEW D. NEIBERG PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5602	AZ
2	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5602	OTHER	AZ	LICENSE#

General Provider Information

NPI Number	:	1356451538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW D. NEIBERG PT

Provider Business Mailing Address
First Line	:	13540 W CAMINO DEL SOL STE 6
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-4435
Country	:	US
Telephone Number	:	623-556-5013
Fax Number	:	623-556-9290

Provider Business Practice Location Address
First Line	:	13540 W CAMINO DEL SOL STE 6
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-4435
Country	:	US
Telephone Number	:	623-556-5013
Fax Number	:	623-556-9290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/19/2024

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Directions to “ MR. MATTHEW D. NEIBERG PT” Practice Location

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