MEDICARE: MR. MATTHEW DONALD HARPER P.T.

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	P11203	NC

General Provider Information

NPI Number	:	1851555452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW DONALD HARPER P.T.

Provider Business Mailing Address
First Line	:	2415 SANDY PORTER RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-3695
Country	:	US
Telephone Number	:	704-583-0430
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 SANDY PORTER RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-3695
Country	:	US
Telephone Number	:	704-583-0430
Fax Number	:

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

Provider Enumeration Date	:	07/12/2008
Last Update Date	:	07/12/2008

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