Individual
MATTHEW TEMBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10472
MN
225100000X
Physical Therapist
2305210154
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0064-0032705
MEDICA
MN
Enumeration date
05/16/2016
Last updated
08/08/2016
Update your record
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