NPI 1053787689

Matthew Scott Mazara, PTA

Practitioner Physical Therapy Assistant Diberville, MS

Practice location

Address: 10470 Diberville Blvd, Diberville, MS 39540-2419
Phone: (228) 280-8120
Fax: (228) 280-8121

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 5837 (MS)

Other Physical Therapy Assistant providers in Mississippi →

Registry record

NPI: 1053787689
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Aug 2015
Record last updated: 18 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.