MEDICARE: IAN MATTHEW SCHALLER

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	225700000X	Massage Therapist	20261242370	CO

General Provider Information

NPI Number	:	1114872173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IAN MATTHEW SCHALLER

Provider Business Mailing Address
First Line	:	420 S HOWES ST STE 201A
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2871
Country	:	US
Telephone Number	:	970-237-0346
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 S HOWES ST STE 201A
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2871
Country	:	US
Telephone Number	:	970-237-0346
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ IAN MATTHEW SCHALLER ” Practice Location

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