Individual
MATTHEW CARTER WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4324 RIDGEWATER DR, LEXINGTON, KY 40515-5200
(859) 271-3034
Mailing address
4324 RIDGEWATER DR, LEXINGTON, KY 40515-5200
(859) 271-3034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008625
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W13-380-025
DRIVERS LICENSE
KY
Enumeration date
02/27/2023
Last updated
02/27/2023
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