Provider Demographics
NPI:1669253803
Name:MARTING, SUMMER GRACE (DPT)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:GRACE
Last Name:MARTING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2647 FRONT ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-5021
Mailing Address - Country:US
Mailing Address - Phone:719-660-2698
Mailing Address - Fax:
Practice Address - Street 1:711 N TEJON ST # 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1011
Practice Address - Country:US
Practice Address - Phone:719-381-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019292225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist