Individual
MATTHEW BRIAN BANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Contact information
Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
Mailing address
4 VILLAGE GREEN CIR, MOUNTAIN TOP, PA 18707-1710
(570) 574-4126
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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