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NPI Code Detail

MEDICARE: MATTHEW D SUBLER PT, AT

MEDICARE: MATTHEW D SUBLER PT, AT
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
12255A2300XAthletic Trainer
2225100000XPhysical Therapist019850OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11952814451OTHEROHATC

General Provider Information

NPI Number : 1952814451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW D SUBLER PT, AT
Provider Business Mailing Address
First Line : 8906 PITSENBARGER RD
Second Line :
City : VERSAILLES
State : OH
Zip : 45380-9713
Country : US
Telephone Number : 937-621-5891
Fax Number :
Provider Business Practice Location Address
First Line : 216 W MAIN ST
Second Line :
City : COLDWATER
State : OH
Zip : 45828-1703
Country : US
Telephone Number : 419-763-1464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2017
Last Update Date : 05/19/2022

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