Provider Demographics
NPI:1154461804
Name:MARQUARDT, KANDI J (LMT, CNMT)
Entity Type:Individual
Prefix:
First Name:KANDI
Middle Name:J
Last Name:MARQUARDT
Suffix:
Gender:F
Credentials:LMT, CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 W COLORADO AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-2481
Mailing Address - Country:US
Mailing Address - Phone:719-635-8809
Mailing Address - Fax:
Practice Address - Street 1:2812 W COLORADO AVE STE 106
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-2481
Practice Address - Country:US
Practice Address - Phone:719-635-8809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO130870225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist