Matthew Donald Dover, PTA

Individual provider Active NPI Physical Therapy Assistant · Wahoo, NE

NPI 1669899423 · NPPES record last updated Mar 18, 2014

Key facts

NPI
1669899423
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1045 (NE)
Practice address
1760 County Road J
Wahoo, NE 68066-4152
Phone
(402) 443-4191
Fax
(402) 443-1445
NPI assigned
Mar 18, 2014
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1045 NE Yes

Addresses

Primary practice location

1760 County Road J
Wahoo, NE 68066-4152

Mailing address

1760 County Road J
Wahoo, NE 68066-4152
Phone (402) 443-4191

Other providers in Wahoo, NE

All providers in Wahoo, NE · Physical Therapy Assistant in Nebraska

Sources for this page

Verify at the official NPI Registry.