Provider Demographics
NPI:1467257667
Name:KINNEY, MATTHEW (LMT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KINNEY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:
Other - Last Name:KINNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:347 E HILLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-2511
Mailing Address - Country:US
Mailing Address - Phone:610-716-3242
Mailing Address - Fax:
Practice Address - Street 1:403D GORDON DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1249
Practice Address - Country:US
Practice Address - Phone:484-341-8598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG015339225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist