Provider Demographics
NPI:1396570636
Name:PAULSEN, MATTHEW THOMAS HILLYER (DPT, PT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:THOMAS HILLYER
Last Name:PAULSEN
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Gender:M
Credentials:DPT, PT
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Mailing Address - Street 1:1450 E PRATER WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8973
Mailing Address - Country:US
Mailing Address - Phone:775-853-9966
Mailing Address - Fax:775-853-9969
Practice Address - Street 1:734 S MEADOWS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4807
Practice Address - Country:US
Practice Address - Phone:775-853-9966
Practice Address - Fax:775-853-9969
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV6488225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist