Provider Demographics
NPI:1831215243
Name:CLARKE, MARCIA A (PT)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:A
Last Name:CLARKE
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 1:7730 E. BELLEVIEW AVE
Mailing Address - Street 2:SUITE A-104
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-327-5511
Mailing Address - Fax:303-327-5512
Practice Address - Street 1:7730 E. BELLEVIEW AVE
Practice Address - Street 2:SUITE A-104
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-327-5511
Practice Address - Fax:303-327-5512
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist