Provider Demographics
NPI:1730237272
Name:SOLKA, MATTHEW J (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:SOLKA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47420 HWY M26 STE 46
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:49931-2819
Mailing Address - Country:US
Mailing Address - Phone:906-483-4800
Mailing Address - Fax:906-483-3972
Practice Address - Street 1:47420 HWY M26 STE 46
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-2819
Practice Address - Country:US
Practice Address - Phone:906-483-4800
Practice Address - Fax:906-483-3972
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013593225100000X
MT1874PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5341001OtherMEDICARE INDIVIDUAL