Individual
MATTHEW RICHARD BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103
(720) 592-5310
Mailing address
402 E LIBERTY DR, WHEATON, IL 60187-5511
(720) 592-5310
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
17033
CO
2251X0800X
Orthopedic Physical Therapist
Primary
17033
CO
Other
Enumeration date
07/28/2020
Last updated
06/10/2024
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