MEDICARE: SUZANNE M MATSUMOTO MPT

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
1	225100000X	Physical Therapist	3374	AZ

General Provider Information

NPI Number	:	1578560975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE M MATSUMOTO MPT

Provider Business Mailing Address
First Line	:	28648 N 108TH WAY
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85262-4648
Country	:	US
Telephone Number	:	602-617-4014
Fax Number	:

Provider Business Practice Location Address
First Line	:	28648 N 108TH WAY
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85262-4648
Country	:	US
Telephone Number	:	602-617-4014
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/07/2023

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Directions to “ SUZANNE M MATSUMOTO MPT” Practice Location

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