Individual
MATTHEW J OPOLKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12243-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12243-24
LICENSE
WI
Enumeration date
04/01/2013
Last updated
02/08/2023
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