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NPI Code Detail

MEDICARE: BETHANY MATHISON

MEDICARE: BETHANY MATHISON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0019XPhysical Rehabilitation Occupational Therapist

General Provider Information

NPI Number : 1154255149
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY MATHISON
Provider Business Mailing Address
First Line : 3782 WINSTON DR APT 73
Second Line :
City : LAFAYETTE
State : IN
Zip : 47905-8584
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 S CREASY LN
Second Line :
City : LAFAYETTE
State : IN
Zip : 47905-4972
Country : US
Telephone Number : 765-502-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “ BETHANY MATHISON ” Practice Location

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