Provider Demographics
NPI:1356048839
Name:SELLEN, MATTHEW KEVIN (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:KEVIN
Last Name:SELLEN
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 1:799 E HAMPDEN AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2762
Mailing Address - Country:US
Mailing Address - Phone:720-328-5055
Mailing Address - Fax:720-387-8149
Practice Address - Street 1:799 E HAMPDEN AVE STE 303
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2762
Practice Address - Country:US
Practice Address - Phone:720-328-5055
Practice Address - Fax:720-387-8149
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist