Individual ProviderMatthew Austin ClarkPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address16611 S 40th St Ste 130, Phoenix, AZ 85048-0564(480) 706-1199(602) 329-8250PECOS EnrollmentBased on the most recent information from CMS, provider Matthew Austin Clark does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1083205629Provider TypeIndividualFull NameClark, Matthew AustinCredentialDPTGenderMaleSole ProprietorNoEnumeration Date1/27/2021Last Updated2/23/2022Contact InformationPractice LocationPractice Address16611 S 40th St Ste 130, Phoenix, AZ 85048-0564Phone(480) 706-1199Fax(480) 706-3999Mailing LocationMailing Address14287 N 87th St Ste 220, Scottsdale, AZ 85260-3698Phone(602) 329-8250Fax(480) 565-1898Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense31552Arizona