Individual
MATTHEW ALEXANDER BEVACQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Mailing address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
047378
NY
225100000X
Physical Therapist
13136
CT
225100000X
Physical Therapist
Primary
25503
MD
225100000X
Physical Therapist
25535
MA
225100000X
Physical Therapist
40QA02019100
NJ
225100000X
Physical Therapist
5501301792
MI
225100000X
Physical Therapist
J1-0014396
DE
225100000X
Physical Therapist
PT03402
RI
225100000X
Physical Therapist
PT200001236
DC
225100000X
Physical Therapist
PT5966
ME
Other
Enumeration date
06/17/2015
Last updated
03/03/2022
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