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Matthew Shane Evans, CPO
Prosthetic/Orthotic Supplier in Modesto, California
NPI 1245476597

Matthew Shane Evans is a Prosthetic/Orthotic Supplier based in Modesto, CA. Matthew Shane Evans practices in Modesto, CA and has the professional credentials of CPO. The NPI Number for Matthew Shane Evans is 1245476597 and holds a License No. CPO02042 (California).

The current practice location address for Matthew Shane Evans is 1705 Coffee Rd, Modesto, CA and can be reached out via phone at 209-544-2273 and via fax at 209-544-2274. You can also correspond with Matthew Shane Evans through the mailing address at 1705 COFFEE RD, MODESTO, CA - 95355-2809 (mailing address contact number: 209-544-2273).

Location: 1705 Coffee Rd, Modesto, CA, 95355-2809
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245476597
Provider Name
Matthew Shane Evans
Credential
CPO
Provider Entity Type
Individual
Gender
Male
Address
1705 Coffee Rd, Modesto, CA, 95355-2809
Phone Number
209-544-2273
Fax Number
209-544-2274
Provider Enumeration Date
12/16/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XC0020420 05 CA
institution
Provider Business Practice Location Address Details
Address
1705 Coffee Rd
City
Modesto
State
California
Zip
95355-2809
Phone Number
209-544-2273
Fax Number
209-544-2274
person
Provider Business Mailing Address Details
Address
1705 Coffee Rd
City
Modesto
State
California
Zip
95355-2809
Phone Number
209-544-2273
Fax Number
209-544-2274
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Orthotist
Speciality
-
Taxonomy
222Z00000X
License No.
CPO02042 (California)
Definition
A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Pedorthist
Speciality
-
Taxonomy
224L00000X
License No.
CPO02042 (California)
Definition
An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.
person
Provider's Taxonomy Details 3
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Prosthetist
Speciality
-
Taxonomy
224P00000X
License No.
CPO02042 (California)
Definition
A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
person
Provider's Taxonomy Details 4
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
CPO02042 (California)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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