Provider Demographics
NPI:1588615942
Name:SCHELLING, MATTHEW J (MA, MSPT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:J
Last Name:SCHELLING
Suffix:
Gender:M
Credentials:MA, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 DANIEL DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2527
Mailing Address - Country:US
Mailing Address - Phone:859-236-4686
Mailing Address - Fax:859-236-4624
Practice Address - Street 1:76 C MICHAEL DAVENPORT BLVD STE 2
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4390
Practice Address - Country:US
Practice Address - Phone:859-329-9496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0743202Medicare PIN