Individual
KYLE A MATSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2121 WILLOW ST, VINCENNES, IN 47591-5355
(812) 882-1141
(812) 255-0045
Mailing address
7300 E INDIANA ST, SUITE 102, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
006074
KY
225100000X
Physical Therapist
Primary
05010551A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000730546
BLUE CROSS BLUE SHIELD
IN
01
—
000000730562
BLUE CROSS BLUE SHIELD
IN
05
—
201029970
—
IN
Enumeration date
07/18/2011
Last updated
06/18/2013
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