Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 10906 | CA |
NPI | 1407349392 |
---|---|
Provider Name | Susan Lynn Matthews |
First Address | Sacramento, CA 95815-4035 |
Second Address | Sacramento, CA 95815-4035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2018 |
Last Update Date | 14/06/2018 |