Provider Demographics
NPI:1376096701
Name:MARCHANT, SALLIE (DP)
Entity Type:Individual
Prefix:
First Name:SALLIE
Middle Name:
Last Name:MARCHANT
Suffix:
Gender:F
Credentials:DP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 W 32ND AVE
Mailing Address - Street 2:APT 307
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3266
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2860 W 32ND AVE
Practice Address - Street 2:APT 307
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3266
Practice Address - Country:US
Practice Address - Phone:803-603-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist