Individual
SHANE ASHLEY MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2121 E HARMONY RD, STE 100, FORT COLLINS, CO 80528-3400
(970) 221-1000
(970) 297-6860
Mailing address
2121 E HARMONY RD, SUITE 100, FORT COLLINS, CO 80528-3400
(970) 221-1000
(970) 297-6860
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3370
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05505810
—
CO
Enumeration date
12/30/2011
Last updated
06/12/2014
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