Provider Demographics
NPI:1922775907
Name:DAVIDSON, MATTHEW SCOT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:SCOT
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 OLD STATE RD N
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-9375
Mailing Address - Country:US
Mailing Address - Phone:419-921-4627
Mailing Address - Fax:
Practice Address - Street 1:1501 BRIGHT RD
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-5463
Practice Address - Country:US
Practice Address - Phone:419-424-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT019476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist