Healthcare Provider Details

I. General information

NPI: 1194501593
Provider Name (Legal Business Name): MATTHEW C BENDER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 BAKER ST
LONGMONT CO
80501-3452
US

IV. Provider business mailing address

PO BOX 5718
KALISPELL MT
59903-5718
US

V. Phone/Fax

Practice location:
  • Phone: 303-772-2255
  • Fax: 303-774-1395
Mailing address:
  • Phone: 406-756-0134
  • Fax: 406-309-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019724
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: