Provider Demographics
NPI:1457736647
Name:POPE, MATTHEW
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:POPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4795 FULTON INDUSTRIAL BLVD SW
Mailing Address - Street 2:SUITE F
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30336-2000
Mailing Address - Country:US
Mailing Address - Phone:404-267-5700
Mailing Address - Fax:
Practice Address - Street 1:4795 FULTON INDUSTRIAL BLVD SW
Practice Address - Street 2:SUITE F
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30336-2000
Practice Address - Country:US
Practice Address - Phone:404-267-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant