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General NPI Number Information
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NPI Number | 1104656891
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Entity Type | Individual
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Provider Name | PEYTON MATTHEW CARDIFF DPT
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Gender | Male
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Dates
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Enumeration Date | 08/06/2024
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 2120 AIRWAY AVE
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City | KINGMAN
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State | AZ
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Zip | 86409-3652
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Country | US
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Telephone | 928-757-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 HIGHWAY 95 STE B390
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-9013
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Country | US
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Telephone | 928-610-2001
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Fax | 928-610-2002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-033702
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License Number State | AZ
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