Doctor Name: | MATTHEW D. IRONSIDE |
NPI Number: | 1326272832 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | 11174-24 |
Business Practice Address: | 410 Dewey St Wisconsin Rapids, WI - 544958080 |
Business Phone Number: | 7154248500 |
Business Fax Number: | 7154248502 |
Mailing Address: | P.o. Box 8080, 410 Dewey St WISCONSIN RAPIDS |
State: | WI |
Postal Code: | 544958080 |
Phone Number: | 7154248500 |
Fax Number: | 7154248502 |
NPI Enumeration Date: | 05/12/2009 |
NPI Last Update Date: | 03/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 11174-24 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
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 |