Individual
MATTHEW WALLENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
191 SWANSON AVE, LAKE HAVASU CITY, AZ 86403-6699
(928) 855-7880
(928) 855-7881
Mailing address
191 SWANSON AVE, LAKE HAVASU CITY, AZ 86403-6699
(928) 855-7880
(928) 855-7881
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
015022
AZ
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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