Provider Demographics
NPI:1952622029
Name:BATEMAN, MATTHEW (CO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BATEMAN
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S CANDY LN STE B1
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4184
Mailing Address - Country:US
Mailing Address - Phone:928-639-1211
Mailing Address - Fax:
Practice Address - Street 1:115 S CANDY LN STE B1
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4184
Practice Address - Country:US
Practice Address - Phone:928-639-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist