Doctor Name: | MATTHEW EDWARD WATERS |
NPI Number: | 1457695322 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | J1-0002910 |
Business Practice Address: | 28535 Dupont Blvd Unit 1 Millsboro, DE - 199664799 |
Business Phone Number: | 3022970700 |
Business Fax Number: | |
Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
State: | IL |
Postal Code: | 604404909 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/16/2012 |
NPI Last Update Date: | 12/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | J1-0002910 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
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 |