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General NPI Number Information
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NPI Number | 1992685655
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Entity Type | Individual
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Provider Name | DYLAN MATTHEW WALDROP PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 102 W MAPLE ST
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City | SCOTTSVILLE
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State | KY
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Zip | 42164-1134
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Country | US
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Telephone | 270-239-6640
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Fax |
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Provider Business Mailing Address
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Address Line | 250 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1760
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Country | US
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Telephone | 270-796-6200
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 009403
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License Number State | KY
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