Provider Demographics
NPI:1396985834
Name:MATHIES, JOEL WALTER (COTA)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:WALTER
Last Name:MATHIES
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4048 S FUNDY WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013
Mailing Address - Country:US
Mailing Address - Phone:303-625-3943
Mailing Address - Fax:
Practice Address - Street 1:4048 S FUNDY WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-4552
Practice Address - Country:US
Practice Address - Phone:303-625-3943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant