Provider Demographics
NPI:1346323912
Name:LUGINBUHL, MATTHEW KENT (PT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:KENT
Last Name:LUGINBUHL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:84 SNIPSIC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-3519
Mailing Address - Country:US
Mailing Address - Phone:860-871-6815
Mailing Address - Fax:860-875-6423
Practice Address - Street 1:936 SILAS DEANE HWY STE 3B
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4273
Practice Address - Country:US
Practice Address - Phone:860-306-6423
Practice Address - Fax:860-875-6423
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT55832251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics