Gibbons, Matthew
Gibbons, Matthew is an individual health care provider with primary practice located at W229N1416 Westwood Dr Ste 4 , Waukesha WI 53186-1309. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Gibbons, Matthew can be contacted via phone (262) 349-9297.Contact Information
Primary practice address
W229N1416 Westwood Dr Ste 4
Waukesha WI 53186-1309
Phone: (262) 349-9297
Fax: (262) 278-4062
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 10389-024 | Wisconsin |
Profile Details
| NPI number | 1659352938 |
|---|---|
| LBN Legal business name | Gibbons, Matthew |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2005 |
| Last updated | Mar 25th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659352938 | NPPES |
| Wisconsin | Other | P00231054 | RAILROAD MEDICARE IND # |
| Wisconsin | MEDICAID | 40455400 | RAILROAD MEDICARE IND # |
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