Provider Demographics
NPI:1144620899
Name:BRINKERHOFF, MATTHEW (ATC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BRINKERHOFF
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 N 100 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1211
Mailing Address - Country:US
Mailing Address - Phone:801-228-7733
Mailing Address - Fax:
Practice Address - Street 1:1247 N 100 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-1211
Practice Address - Country:US
Practice Address - Phone:801-228-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-31
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT567160948102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer