Provider Demographics
NPI:1659726065
Name:NASTA, MATTHEW (CMT CERTIFIED ROLFER)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:NASTA
Suffix:
Gender:M
Credentials:CMT CERTIFIED ROLFER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2883 28TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:303-442-4202
Mailing Address - Fax:
Practice Address - Street 1:2883 28TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:303-442-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor