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NPI Code Detail

MEDICARE: MR. MATTHEW JOSEPH EATON DPT

MEDICARE: MR. MATTHEW JOSEPH EATON 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 Therapist10155LA

General Provider Information

NPI Number : 1861105736
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW JOSEPH EATON DPT
Provider Business Mailing Address
First Line : 205 WHEATFIELD DR
Second Line :
City : DUSON
State : LA
Zip : 70529-4217
Country : US
Telephone Number : 337-212-1367
Fax Number :
Provider Business Practice Location Address
First Line : 1202 3RD ST W
Second Line :
City : ROUNDUP
State : MT
Zip : 59072-1816
Country : US
Telephone Number : 406-323-2301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2023
Last Update Date : 01/05/2023

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