Provider Demographics
NPI:1669503884
Name:TOUCHTON, MARYBETH T (PT)
Entity Type:Individual
Prefix:
First Name:MARYBETH
Middle Name:T
Last Name:TOUCHTON
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 1:5268 STREAMBED TRL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5132
Mailing Address - Country:US
Mailing Address - Phone:720-545-5757
Mailing Address - Fax:
Practice Address - Street 1:5268 STREAMBED TRL
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5132
Practice Address - Country:US
Practice Address - Phone:720-545-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2625174400000X
CO00104982251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No174400000XOther Service ProvidersSpecialist