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General NPI Number Information
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NPI Number | 1083402630
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Entity Type | Organization
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Legal Business Name | MATSAN THERAPY & REHAB, LLC
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 4010 DUPONT CIR STE 569
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City | LOUISVILLE
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State | KY
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Zip | 40207-4888
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Country | US
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Telephone | 502-276-1959
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Fax |
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Provider Business Mailing Address
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Address Line | 4010 DUPONT CIR STE 569
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City | LOUISVILLE
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State | KY
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Zip | 40207-4888
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GIANNYS MATO
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Credential |
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Telephone | 502-276-1959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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