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Individual

MR. ANTHONY MATULIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(317) 573-1037
Mailing address
118 MEDICAL DR, CARMEL, IN 46032-3323

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004018A
IN
282N00000X
General Acute Care Hospital
5671
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5671
STATE LICENSE
NC
Enumeration date
11/02/2006
Last updated
09/10/2021
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