| Doctor Name: | DR. MATTHEW MYCHAL ZELLMER |
| NPI Number: | 1942659719 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT, ATR, CSCS |
| License Number: | 10266 |
| Business Practice Address: | 688 Wildwood Rd Mahtomedi, MN - 551151812 |
| Business Phone Number: | 6514299947 |
| Business Fax Number: | |
| Mailing Address: | 401 Sibley St, Apt. 539 SAINT PAUL |
| State: | MN |
| Postal Code: | 551011942 |
| Phone Number: | 5074403327 |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2016 |
| NPI Last Update Date: | 06/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 10266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| 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 |