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General NPI Number Information
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NPI Number | 1265329338
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Entity Type | Individual
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Provider Name | MR. MATTHEW DANIEL LEMMERMAN
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Gender | Male
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Dates
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Enumeration Date | 06/21/2025
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 800 W MAIN ST
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City | COLDWATER
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State | OH
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Zip | 45828-1613
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Country | US
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Telephone | 419-678-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 854 LAKE AVE
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City | SAINT MARYS
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State | OH
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Zip | 45885-2734
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Country | US
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Telephone | 419-953-4962
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 010649
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License Number State | OH
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