Provider Demographics
NPI:1770022030
Name:FRANZINO, MATT (PTA)
Entity Type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:FRANZINO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 S ALTON WAY
Mailing Address - Street 2:STE. 6L
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2334
Mailing Address - Country:US
Mailing Address - Phone:303-790-4495
Mailing Address - Fax:720-488-1988
Practice Address - Street 1:6660 TIMBERLINE RD
Practice Address - Street 2:110
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5345
Practice Address - Country:US
Practice Address - Phone:303-683-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014017174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist