Provider Demographics
NPI:1841500535
Name:GUENIOT, MARC KENNON (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:KENNON
Last Name:GUENIOT
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HONEY LOCUST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3543
Mailing Address - Country:US
Mailing Address - Phone:720-768-8588
Mailing Address - Fax:
Practice Address - Street 1:31 HONEY LOCUST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3543
Practice Address - Country:US
Practice Address - Phone:720-768-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015867225100000X
LAA7904225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant