Provider Demographics
NPI:1720169733
Name:MATTHEWS, NANCY KAE (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:KAE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13606 XAVIER LN STE C
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3604
Mailing Address - Country:US
Mailing Address - Phone:303-404-9494
Mailing Address - Fax:303-404-2252
Practice Address - Street 1:13606 XAVIER LN STE C
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3604
Practice Address - Country:US
Practice Address - Phone:303-404-9494
Practice Address - Fax:303-404-2252
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCOPT8651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist