Individual
MATTHEW SCOTT ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
700 GENEVA PKWY N, LAKE GENEVA, WI 53147-4594
(262) 877-2124
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10990-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36177700
—
WI
Enumeration date
06/17/2008
Last updated
12/05/2025
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