Provider Demographics
NPI:1093062382
Name:BOBMAN, MATT JAMES (PT)
Entity Type:Individual
Prefix:DR
First Name:MATT
Middle Name:JAMES
Last Name:BOBMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7065 N MAPLE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-8013
Mailing Address - Country:US
Mailing Address - Phone:559-299-9989
Mailing Address - Fax:
Practice Address - Street 1:7065 N MAPLE AVE STE 104
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-8013
Practice Address - Country:US
Practice Address - Phone:559-299-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 39205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist