Provider Demographics
NPI:1609034255
Name:STRANG, MATTHEW R (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:R
Last Name:STRANG
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80217
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-0217
Mailing Address - Country:US
Mailing Address - Phone:602-385-2115
Mailing Address - Fax:480-418-3323
Practice Address - Street 1:2940 E BANNER GATEWAY DR STE 250
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2168
Practice Address - Country:US
Practice Address - Phone:602-772-3804
Practice Address - Fax:480-422-6554
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-004134225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1568521821Medicare NSC
AZ1396928073Medicare NSC
AZ1871652131Medicare NSC
AZ1124187489Medicare NSC
AZ1629137997Medicare NSC
AZ1700061363Medicare NSC
AZ1265647879Medicare NSC
AZ1831211143Medicare NSC
AZ1164581427Medicare NSC
AZ1396819546Medicare NSC
AZZ113264Medicare PIN