Basic Information
| Provider Information | |||||||||
| NPI: | 1023513223 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ZEIGLER | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1834 YAQUINA DR | ||||||||
| Address2: | |||||||||
| City: | POST FALLS | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838547363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2088195262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1224 E WESTVIEW CT | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992183813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094658800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2018 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | P160806951 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.