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Individual

ANTHONY V MATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
6405 ROSEWOOD ST, SUITE B, LAKE OSWEGO, OR 97035-5284
(503) 675-7603
(503) 675-7611
Mailing address
5023 SE MARTINS ST, PORTLAND, OR 97206-6963
(503) 246-0919

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2805
OR

Other

Enumeration date
03/26/2007
Last updated
07/08/2007
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