Provider Demographics
NPI:1881458453
Name:PERRY, MASON (DPT)
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:PERRY
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 1:2905 INCA ST UNIT 4006
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1980
Mailing Address - Country:US
Mailing Address - Phone:585-645-2134
Mailing Address - Fax:
Practice Address - Street 1:1805 SHEA CENTER DR STE 160
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2253
Practice Address - Country:US
Practice Address - Phone:720-480-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist