Individual
MATTHEW DAVID HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 ADAMS ST, AFTON, WY 83110-9621
(307) 885-5800
(307) 885-5865
Mailing address
96 DOC PERKES LANE, AFTON, WY 83110-9621
(307) 885-7878
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1472
WY
2251X0800X
Orthopedic Physical Therapist
PT-2970
ID
Other
Enumeration date
07/03/2012
Last updated
04/10/2013
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