MEDICARE: MR. MATHEW AARON BARRY 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	34561	CA

General Provider Information

NPI Number	:	1689844532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATHEW AARON BARRY MPT

Provider Business Mailing Address
First Line	:	3807 GRESHAM LN
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95835-2065
Country	:	US
Telephone Number	:	916-397-2825
Fax Number	:

Provider Business Practice Location Address
First Line	:	3807 GRESHAM LN
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95835-2065
Country	:	US
Telephone Number	:	916-397-2825
Fax Number	:

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

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	07/15/2010

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