Individual
MR. CHARLES MATHEW CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
9160 W 64TH AVE, ARVADA, CO 80004-3111
(303) 420-7258
Mailing address
10703 MOORE WAY, WESTMINSTER, CO 80021-3629
(303) 464-1152
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-0616
WY
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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