MEDICARE: MR. COLIN MATTHEW NORDSTROM MPT

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	2251X0800X	Orthopedic Physical Therapist	1162080	TX

General Provider Information

NPI Number	:	1831310242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. COLIN MATTHEW NORDSTROM MPT

Provider Business Mailing Address
First Line	:	701 OAKLANDS DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4029
Country	:	US
Telephone Number	:	707-771-5160
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 OAKLANDS DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4029
Country	:	US
Telephone Number	:	707-771-5160
Fax Number	:

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	02/06/2024

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