Individual
MARK R MATEJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT/PT
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER AMC, HI 96859-5001
(808) 433-6661
(808) 433-1551
Mailing address
1 JARRETT WHITE RD, TRIPLER AMC, HI 96859-5001
(808) 433-6661
(808) 433-1551
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2154
NV
225100000X
Physical Therapist
Primary
PT4639
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346432309
—
NV
Enumeration date
08/14/2007
Last updated
07/26/2023
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