Provider Demographics
NPI:1881883296
Name:COLGAN, MATTHEW NOEL (OTRL)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:NOEL
Last Name:COLGAN
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1861 POWDER MILL ROAD
Mailing Address - Street 2:ATTN MEDICAL STAFF OFFICE
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4723
Mailing Address - Country:US
Mailing Address - Phone:717-718-2041
Mailing Address - Fax:717-747-2102
Practice Address - Street 1:470 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331
Practice Address - Country:US
Practice Address - Phone:717-747-8361
Practice Address - Fax:717-747-2114
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009552225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist