Provider Demographics
NPI:1922289768
Name:COLON, MARSHA TRACELYN EDWARDS (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:TRACELYN EDWARDS
Last Name:COLON
Suffix:
Gender:F
Credentials:MSPT
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Mailing Address - Street 1:10529 BLAZING STAR LOOP
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-2212
Mailing Address - Country:US
Mailing Address - Phone:301-452-2168
Mailing Address - Fax:
Practice Address - Street 1:19441 GOLF VISTA PLZ STE 340
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8272
Practice Address - Country:US
Practice Address - Phone:703-723-7726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist