Provider Demographics
NPI:1770693327
Name:MATHEWSON, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:MATHEWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20885 E SUSSEX CT
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7365
Mailing Address - Country:US
Mailing Address - Phone:303-766-5478
Mailing Address - Fax:
Practice Address - Street 1:3102 S PARKER RD
Practice Address - Street 2:SUITE A-15
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3176
Practice Address - Country:US
Practice Address - Phone:303-338-8598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO6715OtherLICENSE