MEDICARE: J MATTHEW HANLING PT, CERT, MDT

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	J10000534	DE
2	225100000X	Physical Therapist	PT0052927L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S53652	OTHER	DE	BCBS PROVIDER ID
2	5707453	OTHER	DE	AETNA PROVIDER ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780687053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	J MATTHEW HANLING PT, CERT, MDT

Provider Business Mailing Address
First Line	:	5307 LIMESTONE ROAD
Second Line	:	SUITE 203
City	:	WILMINGTON
State	:	DE
Zip	:	19808
Country	:	US
Telephone Number	:	302-234-8170
Fax Number	:	302-234-8174

Provider Business Practice Location Address
First Line	:	5307 LIMESTONE RD
Second Line	:	SUITE 203
City	:	WILMINGTON
State	:	DE
Zip	:	19808-1268
Country	:	US
Telephone Number	:	302-234-8170
Fax Number	:	302-234-8174

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/30/2015

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