Provider Demographics
NPI:1750735734
Name:MATTYG LLC
Entity type:Organization
Organization Name:MATTYG LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GIULIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:918-280-0180
Mailing Address - Street 1:3202 S MEMORIAL DR STE 9
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1323
Mailing Address - Country:US
Mailing Address - Phone:918-280-0180
Mailing Address - Fax:
Practice Address - Street 1:3202 S MEMORIAL DR STE 9
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1323
Practice Address - Country:US
Practice Address - Phone:918-280-0180
Practice Address - Fax:918-280-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty