Doctor Name: | DR. KRISTOFER MATTIS |
NPI Number: | 1184974750 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT, CSCS |
License Number: | 070019403 |
Business Practice Address: | 1000 N Allen St. Robinson, IL - 624542701 |
Business Phone Number: | 6185462695 |
Business Fax Number: | 6185462635 |
Mailing Address: | 1000 N Allen St., ROBINSON |
State: | IL |
Postal Code: | 62454 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/11/2012 |
NPI Last Update Date: | 09/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070019403 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |