Provider Demographics
NPI:1003059775
Name:CLINGMAN, SUSAN MARY (RMT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MARY
Last Name:CLINGMAN
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 S FEDERAL BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-6364
Mailing Address - Country:US
Mailing Address - Phone:303-726-2575
Mailing Address - Fax:
Practice Address - Street 1:5031 S FEDERAL BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-6364
Practice Address - Country:US
Practice Address - Phone:303-726-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2795225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist