Matthew Agner, CTRS

Individual provider Active NPI Recreation Therapist · Salisbury, NC

NPI 1134728611 · NPPES record last updated Oct 26, 2020

Key facts

NPI
1134728611
Entity type
Individual (NPI type 1)
Primary specialty
Recreation Therapist 225800000X
Practice address
1601 Brenner Ave
Salisbury, NC 28144-2515
Phone
(704) 638-9000
NPI assigned
Oct 26, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225800000X Yes

Addresses

Primary practice location

1601 Brenner Ave
Salisbury, NC 28144-2515

Mailing address

1601 Brenner Ave
Salisbury, NC 28144-2515

Other providers in Salisbury, NC

All providers in Salisbury, NC · Recreation Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.