Provider Demographics
NPI:1053450247
Name:FENN, MARGARET KRICK (MS,PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:KRICK
Last Name:FENN
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 E ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1731
Mailing Address - Country:US
Mailing Address - Phone:303-850-7717
Mailing Address - Fax:303-853-7517
Practice Address - Street 1:7120 E ORCHARD RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-1731
Practice Address - Country:US
Practice Address - Phone:303-850-7717
Practice Address - Fax:303-853-7517
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO804150Medicare ID - Type Unspecified