Provider Demographics
NPI:1104844018
Name:ROSCHKE, MARCI (ATC)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:
Last Name:ROSCHKE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 MACARTHUR LN
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1140
Mailing Address - Country:US
Mailing Address - Phone:303-946-3087
Mailing Address - Fax:
Practice Address - Street 1:4650 MACARTHUR LN
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1140
Practice Address - Country:US
Practice Address - Phone:303-946-3087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer