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General NPI Number Information
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NPI Number | 1215949334
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Entity Type | Individual
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Provider Name | MATTHEW R MCMANUS PT
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 ARROW DR SUITE 2
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City | WOBURN
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State | MA
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Zip | 01801-2039
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Country | US
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Telephone | 781-935-2655
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Fax | 781-935-9097
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Provider Business Mailing Address
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Address Line | 7 MAPLE TER
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City | NEWBURY
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State | MA
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Zip | 01951-1108
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Country | US
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Telephone | 781-935-2655
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 13166
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License Number State | MA
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