Provider Demographics
NPI:1255619235
Name:HOWLAND, MATTHEW BUSH (ATC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:BUSH
Last Name:HOWLAND
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 STATE ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-2740
Mailing Address - Country:US
Mailing Address - Phone:802-236-4117
Mailing Address - Fax:
Practice Address - Street 1:203 STATE ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-2740
Practice Address - Country:US
Practice Address - Phone:802-236-4117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104.00001512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer