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General NPI Number Information
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NPI Number | 1457335473
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Entity Type | Individual
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Provider Name | MATTHEW P SHEDLOCK PT
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 N CRAIG ST
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City | PITTSBURGH
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State | PA
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Zip | 15213-1567
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Country | US
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Telephone | 412-622-7522
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Fax | 412-622-7834
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Provider Business Mailing Address
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Address Line | 2587A GROUSE RDG
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City | WEXFORD
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State | PA
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Zip | 15090-7945
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Country | US
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Telephone | 724-940-9347
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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 | PT013135
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License Number State | PA
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