Provider Demographics
NPI:1265031306
Name:EDWARDS, MATTHEW (DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MATTHEW EDWARDS DPT
Mailing Address - Street 1:51 PLUMLY WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2664
Mailing Address - Country:US
Mailing Address - Phone:267-573-9132
Mailing Address - Fax:
Practice Address - Street 1:910 2ND STREET PIKE
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1527
Practice Address - Country:US
Practice Address - Phone:215-436-6194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist