Provider Demographics
NPI:1881378354
Name:KASSIR, MATTHEW (PT, DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KASSIR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 W ASHBY DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4549
Mailing Address - Country:US
Mailing Address - Phone:602-696-6146
Mailing Address - Fax:
Practice Address - Street 1:20801 N SCOTTSDALE RD STE 105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6487
Practice Address - Country:US
Practice Address - Phone:623-208-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32967225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist