Provider Demographics
NPI:1063029312
Name:MCCANN, MATTHEW J (DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:MCCANN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:J
Other - Last Name:MCCANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:228 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1420
Mailing Address - Country:US
Mailing Address - Phone:724-650-6259
Mailing Address - Fax:
Practice Address - Street 1:2284 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-4685
Practice Address - Country:US
Practice Address - Phone:724-788-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist