Provider Demographics
NPI:1396011433
Name:MARCHAND, TOBY DAVID (LAC)
Entity Type:Individual
Prefix:MR
First Name:TOBY
Middle Name:DAVID
Last Name:MARCHAND
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 NORTH ST
Mailing Address - Street 2:106
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3320
Mailing Address - Country:US
Mailing Address - Phone:303-819-9967
Mailing Address - Fax:
Practice Address - Street 1:2760 29TH ST
Practice Address - Street 2:2-D
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1214
Practice Address - Country:US
Practice Address - Phone:303-819-9967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1758171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist