Matthew Harold Altman, PTA

Individual provider Active NPI Physical Therapy Assistant · Fernandina Beach, FL

NPI 1043712904 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1043712904
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PT28249 (FL)
Practice address
1885 S 14TH St
Fernandina Beach, FL 32034-3033
Phone
(904) 277-4449
Fax
(904) 277-4177
NPI assigned
Mar 6, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT28249FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PT28249 FL Yes

Addresses

Primary practice location

1885 S 14TH St
Fernandina Beach, FL 32034-3033

Mailing address

1885 S 14TH St
Fernandina Beach, FL 32034-3033
Phone (904) 277-4449

Other practice location 1

45390 Green Ave
Callahan, FL 32011-3711
Phone (904) 879-1223

Other providers in Fernandina Beach, FL

All providers in Fernandina Beach, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.