Provider Demographics
NPI:1104088467
Name:BIGELOW, MARLENE A (PT)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:A
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARLENE
Other - Middle Name:G
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3425 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5701
Mailing Address - Country:US
Mailing Address - Phone:719-265-6601
Mailing Address - Fax:719-265-6649
Practice Address - Street 1:3425 AUSTIN BLUFFS PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5701
Practice Address - Country:US
Practice Address - Phone:719-265-6601
Practice Address - Fax:719-265-6649
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist