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General NPI Number Information
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NPI Number | 1982695946
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Entity Type | Individual
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Provider Name | MATTHEW CHRISTOPHER HENRY
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5550 N WALNUT ST
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City | MACUNGIE
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State | PA
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Zip | 18062-1323
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Country | US
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Telephone | 610-966-2601
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Fax |
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Provider Business Mailing Address
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Address Line | 2098 BUTLER PIKE APT E4
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1839
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Country | US
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Telephone | 610-730-8939
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 149773
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License Number State | PA
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