Provider Demographics
NPI:1558673400
Name:MCLEAN, MATTHEW ROY (DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ROY
Last Name:MCLEAN
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 1:9150 COMMERCE CENTER CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-1562
Mailing Address - Country:US
Mailing Address - Phone:303-325-2653
Mailing Address - Fax:303-557-2387
Practice Address - Street 1:9150 COMMERCE CENTER CIR STE 200
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-1562
Practice Address - Country:US
Practice Address - Phone:303-325-2653
Practice Address - Fax:303-557-2387
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist