Provider Demographics
NPI:1790211902
Name:MAGER, MARC
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:MAGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:MAGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4695 S MONACO ST STE 111
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3535
Mailing Address - Country:US
Mailing Address - Phone:303-302-6136
Mailing Address - Fax:303-302-1628
Practice Address - Street 1:4695 S MONACO ST STE 111
Practice Address - Street 2:SUITE 111
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-3535
Practice Address - Country:US
Practice Address - Phone:303-302-6136
Practice Address - Fax:303-302-1628
Is Sole Proprietor?:No
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications