Provider Demographics
NPI:1134145436
Name:MARCH, DIANNE C (OT)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:C
Last Name:MARCH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 CENTENNIAL BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4090
Mailing Address - Country:US
Mailing Address - Phone:719-260-4767
Mailing Address - Fax:719-260-4765
Practice Address - Street 1:3470 CENTENNIAL BLVD
Practice Address - Street 2:STE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4090
Practice Address - Country:US
Practice Address - Phone:719-260-4767
Practice Address - Fax:719-260-4765
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOTAA54427225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO806223Medicare PIN