Provider Demographics
NPI:1356051494
Name:PAUL, MATTHEW (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:PAUL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10524 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2205
Mailing Address - Country:US
Mailing Address - Phone:216-444-6262
Mailing Address - Fax:216-444-8548
Practice Address - Street 1:10524 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2205
Practice Address - Country:US
Practice Address - Phone:216-444-6262
Practice Address - Fax:216-444-8548
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT014861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist