Individual
MATTHEW LEE DEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8550 W 38TH AVE, 106B, WHEAT RIDGE, CO 80033-4300
(303) 953-3163
(202) 245-0726
Mailing address
8550 W 38TH AVE, 106B, WHEAT RIDGE, CO 80033-4300
(303) 953-3163
(202) 245-0726
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004571
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665463
—
IA
Enumeration date
05/24/2010
Last updated
05/21/2012
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