Provider Demographics
NPI:1326275371
Name:FREIJE, MATTHEW T (DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:T
Last Name:FREIJE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 SHORE DR
Mailing Address - Street 2:STE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5657
Mailing Address - Country:US
Mailing Address - Phone:317-298-9746
Mailing Address - Fax:317-290-0847
Practice Address - Street 1:3830 SHORE DR
Practice Address - Street 2:STE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5657
Practice Address - Country:US
Practice Address - Phone:317-298-9746
Practice Address - Fax:317-290-0847
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009969A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist