Provider Demographics
NPI:1902037237
Name:MATHEW, SUBASH (PT)
Entity Type:Individual
Prefix:
First Name:SUBASH
Middle Name:
Last Name:MATHEW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11011 S 48TH ST
Mailing Address - Street 2:STE 108
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-1787
Mailing Address - Country:US
Mailing Address - Phone:480-893-2400
Mailing Address - Fax:480-893-2412
Practice Address - Street 1:7166 CATON FARM RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-1695
Practice Address - Country:US
Practice Address - Phone:815-609-3554
Practice Address - Fax:815-609-3556
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2016-10-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist