Healthcare Provider Details

I. General information

NPI: 1083500938
Provider Name (Legal Business Name): MATTHEW A BRYANT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 13TH ST
ASHLAND KY
41102-4510
US

IV. Provider business mailing address

PO BOX 1240
ASHLAND KY
41105-1240
US

V. Phone/Fax

Practice location:
  • Phone: 606-329-0910
  • Fax: 606-325-8434
Mailing address:
  • Phone: 606-325-7955
  • Fax: 606-325-9848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP046726T
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number009337
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: