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General NPI Number Information
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NPI Number | 1841575461
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Entity Type | Individual
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Provider Name | MATTHEW SPILLER P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 1248 MAIN ST
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City | NEWMAN
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State | CA
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Zip | 95360-1346
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Country | US
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Telephone | 209-862-2346
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 GLACIER BAY LN
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City | NEWMAN
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State | CA
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Zip | 95360-9668
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Country | US
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Telephone | 209-862-9800
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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 | 21388
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License Number State | CA
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