Individual
MR. MATTHEW THOMAS KILLIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 N STEPHANIE ST STE 310, HENDERSON, NV 89014-6608
(702) 454-1162
(702) 454-8817
Mailing address
400 N STEPHANIE ST STE 310, HENDERSON, NV 89014-6608
(702) 454-1162
(702) 454-8817
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2398
NV
225100000X
Physical Therapist
PT 16888
FL
225100000X
Physical Therapist
PT16888
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1702161
—
NV
01
—
DU0139
RAILROAD MEDICARE
NV
Enumeration date
01/31/2007
Last updated
05/12/2022
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