Provider Demographics
NPI:1447674502
Name:FRANTZ, MATTHEW (MED, ATC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:FRANTZ
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 QUAD DR
Mailing Address - Street 2:127 KIRBY SPORTS CENTER
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-1798
Mailing Address - Country:US
Mailing Address - Phone:610-330-5919
Mailing Address - Fax:
Practice Address - Street 1:111 QUAD DR
Practice Address - Street 2:127 KIRBY SPORTS CENTER
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-1768
Practice Address - Country:US
Practice Address - Phone:610-330-5919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0052622255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer