Individual
DENISE GAIL MATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2291 WEST FOURTH STREET, SUITE D, MANSFIELD, OH 44906-1261
(419) 589-2238
Mailing address
PO BOX 1086, WILLOUGHBY, OH 44096-1086
(216) 645-7242
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT06506
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000356114
ANTHEM
—
Enumeration date
09/20/2006
Last updated
11/24/2014
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