Individual
MRS. KIMBERLY SUE MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
6330 N FIR RD, GRANGER, IN 46530-4753
(574) 977-8035
Mailing address
336 E 100 S, VALPARAISO, IN 46383-9520
(310) 692-0670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012697A
IN
225100000X
Physical Therapist
L1609583
MI
225100000X
Physical Therapist
PT018989
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417145319
—
PA
Enumeration date
10/05/2007
Last updated
02/22/2022
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