Individual
MR. MATTHEW DAVID TRICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5506 E 16TH ST, SUIT B10, INDIANAPOLIS, IN 46218-4935
(317) 355-5905
Mailing address
9913 ELLSWORTH LN, AVON, IN 46123-8643
(317) 271-6638
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002641
IN
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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