Individual
DANIEL MATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
1185 W CARMEL DR BLDG C, CARMEL, IN 46032-8708
(317) 415-6980
Mailing address
1185 W CARMEL DR BLDG C, CARMEL, IN 46032-8708
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
05007274A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05007274A
PHYSICAL THERAPIST LICENS
IN
05
—
200512650
—
IN
Enumeration date
01/10/2006
Last updated
10/12/2016
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