MEDICARE: MATTHEW JAMES HASTINGS DPT

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	041136-1	NY
2	225100000X	Physical Therapist	16484	CO

General Provider Information

NPI Number	:	1992249866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW JAMES HASTINGS DPT

Provider Business Mailing Address
First Line	:	660 GOLDEN RIDGE RD STE 130
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80401-9541
Country	:	US
Telephone Number	:	303-275-2190
Fax Number	:

Provider Business Practice Location Address
First Line	:	437 S WADSWORTH BLVD UNIT G
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-3134
Country	:	US
Telephone Number	:	303-274-7310
Fax Number	:	720-497-6705

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

Provider Enumeration Date	:	12/13/2016
Last Update Date	:	10/09/2019

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