Individual
MR. MATTHEW JAMES KERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.A
Contact information
Practice address
16002 LAKE SHORE VILLA DR, TAMPA, FL 33613
(813) 968-5093
(813) 968-5934
Mailing address
105 N 5TH AVE, MADILL, OK 73446-1200
(580) 795-3301
(580) 795-7307
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
21681
FL
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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