Individual
MATTHEW LYLE WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PT
Contact information
Practice address
7800 SW DURHAM RD, SUITE 500, TIGARD, OR 97224-7577
(503) 937-0090
(503) 372-5191
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61612
OR
225100000X
Physical Therapist
PT34283
CA
Other
Enumeration date
05/14/2010
Last updated
08/22/2016
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