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General NPI Number Information
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NPI Number | 1497254866
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Entity Type | Individual
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Provider Name | MATTHEW BREWER
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Gender | Male
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 435 N GREGG RD
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City | NIXA
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State | MO
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Zip | 65714-9037
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Country | US
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Telephone | 417-459-6441
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Fax |
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Provider Business Mailing Address
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Address Line | 435 N GREGG RD
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City | NIXA
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State | MO
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Zip | 65714-9037
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Country | US
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Telephone | 417-459-6441
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2018004869
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License Number State | MO
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