Individual
MATTHEW CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
960 S BROADWAY AVE STE 200, BOISE, ID 83706-3667
(208) 433-9211
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(503) 443-6156
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7113
ID
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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