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General NPI Number Information
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NPI Number | 1659153997
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Entity Type | Individual
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Provider Name | MATTHEW MARTIN DPT
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Gender | Male
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Dates
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Enumeration Date | 10/20/2023
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 4605 SAWMILL RD
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City | COLUMBUS
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State | OH
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Zip | 43220-2246
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Country | US
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Telephone | 614-827-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 E BASELINE RD SUITE 140
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City | MESA
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State | AZ
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Zip | 85202
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Country | US
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Telephone | 480-820-7675
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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 | PT020777
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP050073T
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License Number State | AZ
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