Individual
KIRT LYVELL MATTHEWS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3700 TAYLOR GLEN LN NW, CONCORD, NC 28027-3400
(704) 788-6510
Mailing address
631 E CHEVAL DR, FORT MILL, SC 29708-6956
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4637
SC
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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