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Individual

MATT GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3900 S WADSWORTH BLVD, STE 200, LAKEWOOD, CO 80235-2203
(720) 504-0126
Mailing address
1460 W CANAL CT, LITTLETON, CO 80120-5632
(720) 504-0126

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
1001047
CA
171WH0202X
Home Modifications Contractor
132123
MD
171WH0202X
Home Modifications Contractor
2014605400
DE
171WH0202X
Home Modifications Contractor
206632
OR
171WH0202X
Home Modifications Contractor
Primary
2705156243
VA
171WH0202X
Home Modifications Contractor
379703
NM
171WH0202X
Home Modifications Contractor
44690
NE
171WH0202X
Home Modifications Contractor
79204
NV
171WH0202X
Home Modifications Contractor
882879
LA
171WH0202X
Home Modifications Contractor
BC663730
MN
171WH0202X
Home Modifications Contractor
CC AITHRDI864M9
WA
171WH0202X
Home Modifications Contractor
PA112522
PA
171WH0202X
Home Modifications Contractor
R17613
MS

Other

Enumeration date
07/05/2016
Last updated
07/05/2016
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