Provider Demographics
NPI:1114554599
Name:BORG, MARIA BARTLETT (PT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:BARTLETT
Last Name:BORG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 DEXTER ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-5034
Mailing Address - Country:US
Mailing Address - Phone:303-249-5327
Mailing Address - Fax:
Practice Address - Street 1:2000 S CO BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7939
Practice Address - Country:US
Practice Address - Phone:303-249-5327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7289208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation