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General NPI Number Information
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NPI Number | 1124912555
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Entity Type | Individual
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Provider Name | MATTHEW LYNTON WELLER DPT
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Gender | Male
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 9501 OLD ANNAPOLIS RD STE 125
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-6355
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Country | US
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Telephone | 443-605-7657
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Fax |
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Provider Business Mailing Address
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Address Line | 610 THORNBURY CT
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City | WESTMINSTER
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State | MD
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Zip | 21158-3029
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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 |
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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 | 30741
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License Number State | MD
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