Provider Demographics
NPI:1275574188
Name:MATRIX REHABILITATION, INC.
Entity Type:Organization
Organization Name:MATRIX REHABILITATION, INC.
Other - Org Name:ARC PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICIER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:FITPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-644-7824
Mailing Address - Street 1:2300 COIT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3768
Mailing Address - Country:US
Mailing Address - Phone:469-467-8705
Mailing Address - Fax:267-321-2550
Practice Address - Street 1:1240 N LAKEVIEW AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-1847
Practice Address - Country:US
Practice Address - Phone:714-693-1300
Practice Address - Fax:714-693-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA556522Medicare Oscar/Certification