MEDICARE: MATTHEW GUISE DPT

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	PT032529	PA

General Provider Information

NPI Number	:	1629809942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW GUISE DPT

Provider Business Mailing Address
First Line	:	3441 SIMPSON FERRY RD
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-6404
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3441 SIMPSON FERRY RD
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-6404
Country	:	US
Telephone Number	:	717-285-6702
Fax Number	:

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

Provider Enumeration Date	:	08/08/2024
Last Update Date	:	08/23/2024

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