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NPI Code Detail

MEDICARE: MATTHEW QUINN PIONTEK PT, DPT

MEDICARE: MATTHEW QUINN PIONTEK PT, 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
1225100000XPhysical Therapist2022031575MO
2225100000XPhysical Therapist11-07045KS

General Provider Information

NPI Number : 1790415818
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW QUINN PIONTEK PT, DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 908 BALTIMORE AVE STE 101
Second Line :
City : KANSAS CITY
State : MO
Zip : 64105-1707
Country : US
Telephone Number : 816-283-8343
Fax Number : 816-283-8444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2022
Last Update Date : 08/23/2022

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