Provider Demographics
NPI:1770759672
Name:MATHEWS, PATRICIA LYNN (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 BROWN THRUSH RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-6008
Mailing Address - Country:US
Mailing Address - Phone:912-655-5893
Mailing Address - Fax:
Practice Address - Street 1:351 WILMINGTON ISLAND RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-3851
Practice Address - Country:US
Practice Address - Phone:912-898-9711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist