Healthcare Provider Details

I. General information

NPI: 1265566178
Provider Name (Legal Business Name): JANET MARIE MATSON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 12/09/2019
Certification Date: 12/09/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 FREMONT AVE
DUBUQUE IA
52003-7701
US

IV. Provider business mailing address

385 FREMONT AVE
DUBUQUE IA
52003
US

V. Phone/Fax

Practice location:
  • Phone: 563-564-1727
  • Fax:
Mailing address:
  • Phone: 563-583-4288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0712
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070003975
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: