MEDICARE: MATTHEW ALTON BURKS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	0013234	CO
2	2251X0800X	Orthopedic Physical Therapist	1575	WY

General Provider Information

NPI Number	:	1013398247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW ALTON BURKS P.T.

Provider Business Mailing Address
First Line	:	2315 E HARMONY RD STE 170
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-8620
Country	:	US
Telephone Number	:	970-297-6588
Fax Number	:	970-297-6567

Provider Business Practice Location Address
First Line	:	2315 E HARMONY RD STE 170
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-8620
Country	:	US
Telephone Number	:	970-297-6588
Fax Number	:	970-297-6567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2015
Last Update Date	:	02/12/2026

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