Individual
MICHELLE MATHEWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1201 NE ELM ST, PRINEVILLE, OR 97754-1206
(541) 447-6254
Mailing address
PO BOX 7287, BEND, OR 97708-7287
(541) 447-6254
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04170
OR
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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