Provider Demographics
NPI:1598986911
Name:DUNCAN, MATTHEW T (PTA)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:T
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7349
Mailing Address - Country:US
Mailing Address - Phone:484-883-8013
Mailing Address - Fax:
Practice Address - Street 1:1615 E BOOT RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-6001
Practice Address - Country:US
Practice Address - Phone:484-653-4426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE005123L171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor