Provider Demographics
NPI:1558701813
Name:MATHEWS, ANN (LMT)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1662 ROSLYN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT
Practice Address - Street 2:MAIL STOP F743, SUITE 5501
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-1090
Practice Address - Fax:720-848-1277
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT 0000800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist