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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MATT WRATHALL, CM

Active Sole Proprietor

MATT WRATHALL, CM is a Pain Clinic healthcare provider located in REXBURG, Idaho. NPI 1205612405 is currently active in the NPPES registry. Verify at CMS.

Pain Clinic · REXBURG, ID

Registration Details

NPI Number
1205612405
Provider Type
Individual
Gender
Male
NPI Issued
Sep 4, 2023 (2.9662348220173 yrs)
Last Updated
Mar 16, 2025
Sole Proprietor
Yes

Practice Information

Address
663 TREJO ST
REXBURG, ID, 834402579
Browse ID providers · Browse ZIP 83440
Phone
3857584356
Primary Specialty
Pain Clinic
261QP3300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.