Provider Demographics
NPI:1962519876
Name:MATTHEWS, DAVID PETER (ATC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PETER
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 SHERMAN LN
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:VT
Mailing Address - Zip Code:05472-3088
Mailing Address - Country:US
Mailing Address - Phone:802-453-4226
Mailing Address - Fax:
Practice Address - Street 1:219 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1443
Practice Address - Country:US
Practice Address - Phone:802-443-5259
Practice Address - Fax:802-443-2094
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104-0000006174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist