Provider Demographics
NPI:1093045031
Name:HAWK, MARSHA (RMT CNMT)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:HAWK
Suffix:
Gender:F
Credentials:RMT CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LUXURY LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3300
Mailing Address - Country:US
Mailing Address - Phone:719-641-3548
Mailing Address - Fax:719-548-7425
Practice Address - Street 1:7608 N UNION BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3886
Practice Address - Country:US
Practice Address - Phone:719-641-3548
Practice Address - Fax:719-548-7425
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2845225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist