Matt McMillen
Individual provider Active NPI Physical Therapy Assistant · Blanchester, OH
NPI 1669011771 · NPPES record last updated Jan 6, 2020
Key facts
- NPI
- 1669011771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5549 (OH)
- Practice address
- 820 E Center St
Blanchester, OH 45107-1310 - Phone
- (937) 783-4949
- NPI assigned
- Jan 6, 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5549 | OH | MD | Student in an Organized Health Care Education/Training Program |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5549 | OH | Yes |
Addresses
Primary practice location
820 E Center St
Blanchester, OH 45107-1310
Mailing address
5796 Farm Field Dr
Mason, OH 45040-9773
Phone (513) 320-6226
Other providers in Blanchester, OH
- Katherine Malone
- Brian L Martin
- Tera Jean Martin
- Gary Todd McCollister
- Susan T McCollister
- Kathy Rae Meyer
- MH Health Care Services, PC
- Jennifer Leigh Miller
- Logan Miller
- Angela Eve Mullins
All providers in Blanchester, OH · Physical Therapy Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.