Individual
NATHAN MATLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
3429 E LOCUST ST, FORT COLLINS, CO 80524-8548
(970) 231-1431
Mailing address
3429 E LOCUST ST, FORT COLLINS, CO 80524-8548
(970) 231-1431
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0018968
CO
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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