Provider Demographics
NPI:1952778946
Name:STULTS-KOLEHMAINEN, MATTHEW A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:STULTS-KOLEHMAINEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:A
Other - Last Name:STULTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:2000 POST RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5730
Mailing Address - Country:US
Mailing Address - Phone:203-418-9520
Mailing Address - Fax:
Practice Address - Street 1:2000 POST ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5730
Practice Address - Country:US
Practice Address - Phone:203-418-9520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist