Provider Demographics
NPI:1952509226
Name:SMITH, MARCIA B (PHD, PT)
Entity Type:Individual
Prefix:PROF
First Name:MARCIA
Middle Name:B
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 REGIS BLVD
Mailing Address - Street 2:MAIL CODE G-4
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-1154
Mailing Address - Country:US
Mailing Address - Phone:303-964-5306
Mailing Address - Fax:303-964-5474
Practice Address - Street 1:3333 REGIS BLVD
Practice Address - Street 2:MAIL CODE G-4
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-1154
Practice Address - Country:US
Practice Address - Phone:303-964-5306
Practice Address - Fax:303-964-5474
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL-603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPTL-603OtherPHYSICAL THERAPY