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Matt Wrathall, CM — NPI 1205612405, Rexburg, ID | NPI Central

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NPI 1205612405

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Matt Wrathall, CM

NPI 1205612405 · Pain Clinic/Center · Rexburg, ID

Provider details

NPI number: 1205612405
Entity type: Individual
Primary specialty: Pain Clinic/CenterAmbulatory Health Care Facilities
Credential: CM
Sex: Male
Sole proprietor: Yes

Specialties & taxonomies

Pain Clinic/CenterPrimary261QP3300X
Ambulatory Health Care Facilities

Practice location

663 Trejo St

Rexburg, ID 83440-2579

Phone: (385) 758-4356

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

Po Box 151

Menan, ID 83434-0151

Registry dates

Enumerated: 2023-09-04
Last updated: 2025-03-16
Certified: 2025-03-16

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.