Basic Information
| Provider Information | |||||||||
| NPI: | 1629523238 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINSTEDT | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5963 KENTSHIRE DR STE B | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454404253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9378138052 | ||||||||
| FaxNumber: | 9378138056 | ||||||||
| Practice Location | |||||||||
| Address1: | 5017 CEMETERY RD | ||||||||
| Address2: | |||||||||
| City: | HILLIARD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430261641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148191000 | ||||||||
| FaxNumber: | 6148191001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2016 | ||||||||
| LastUpdateDate: | 10/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11097 | TN | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT012673 | GA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT017769 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.