Provider Demographics
NPI:1598933210
Name:WARE, MATTHEW B (PT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:B
Last Name:WARE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1910 N CHURCH ST
Mailing Address - Street 2:STE D
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5632
Mailing Address - Country:US
Mailing Address - Phone:336-274-7480
Mailing Address - Fax:336-274-8903
Practice Address - Street 1:3700 SYMI CIR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4309
Practice Address - Country:US
Practice Address - Phone:252-247-2738
Practice Address - Fax:252-247-3882
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC7533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist