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General NPI Number Information
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NPI Number | 1518232388
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Entity Type | Individual
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Provider Name | MATTHEW ROBERT KNOWLTON DPT
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Gender | Male
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 4700 FOREST DR STE 200B
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City | COLUMBIA
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State | SC
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Zip | 29206-3119
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Country | US
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Telephone | 803-314-5590
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Fax | 803-314-5591
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Provider Business Mailing Address
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Address Line | PO BOX 6069
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City | WEST COLUMBIA
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State | SC
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Zip | 29171-6069
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Country | US
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Telephone | 803-791-2491
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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 | 13057
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License Number State | SC
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