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NPI Code Detail

MEDICARE: SUSAN LYNN MATTHEWS PT

MEDICARE: SUSAN LYNN MATTHEWS PT
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
12251N0400XNeurology Physical Therapist10906CA

General Provider Information

NPI Number : 1407349392
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN LYNN MATTHEWS PT
Provider Business Mailing Address
First Line : 1610 ARDEN WAY STE 195
Second Line :
City : SACRAMENTO
State : CA
Zip : 95815-4035
Country : US
Telephone Number : 510-449-9989
Fax Number : 844-755-6408
Provider Business Practice Location Address
First Line : 1610 ARDEN WAY STE 195
Second Line :
City : SACRAMENTO
State : CA
Zip : 95815-4035
Country : US
Telephone Number : 510-449-9989
Fax Number : 844-755-6408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2018
Last Update Date : 06/14/2018

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Directions to “ SUSAN LYNN MATTHEWS PT” Practice Location

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