Provider Demographics
NPI:1881109536
Name:FLORY, MATTHEW M (ATC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:FLORY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 BRIARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-9108
Mailing Address - Country:US
Mailing Address - Phone:330-705-9877
Mailing Address - Fax:
Practice Address - Street 1:2133 BRIARWOOD ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-9108
Practice Address - Country:US
Practice Address - Phone:330-705-9877
Practice Address - Fax:330-705-9877
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260029202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer