Basic Information
Provider Information
NPI: 1437460706
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MATSEL
FirstName: FRANCES
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ENZLER
OtherFirstName: FRANCES
OtherMiddleName: P
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PT
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 5629
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477165629
CountryCode: US
TelephoneNumber: 8124760409
FaxNumber: 8124761016
Practice Location
Address1: 415 CROSSLAKE DR
Address2: SUITE B
City: EVANSVILLE
State: IN
PostalCode: 477158263
CountryCode: US
TelephoneNumber: 8124760409
FaxNumber: 8124761016
Other Information
ProviderEnumerationDate: 07/01/2010
LastUpdateDate: 01/06/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X05010356AINY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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