MEDICARE: CINDY MATTHEWS-LONG

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	2251G0304X	Geriatric Physical Therapist	1324	SC

General Provider Information

NPI Number	:	1366833279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY MATTHEWS-LONG

Provider Business Mailing Address
First Line	:	828 BELTLINE BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-2063
Country	:	US
Telephone Number	:	803-513-5399
Fax Number	:

Provider Business Practice Location Address
First Line	:	828 BELTLINE BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-2063
Country	:	US
Telephone Number	:	803-513-5399
Fax Number	:

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

Provider Enumeration Date	:	02/13/2015
Last Update Date	:	02/13/2015

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Directions to “ CINDY MATTHEWS-LONG ” Practice Location

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