Provider Demographics
NPI:1578344834
Name:TURK, MATTHEW GENE (DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GENE
Last Name:TURK
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 1:1901 W JESTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50226-1158
Mailing Address - Country:US
Mailing Address - Phone:515-984-9297
Mailing Address - Fax:
Practice Address - Street 1:1021 S 178TH ST STE 101
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3574
Practice Address - Country:US
Practice Address - Phone:402-933-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA121163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist