Provider Demographics
NPI:1588753933
Name:TAPPY, MARLA J (PT, ATC)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:J
Last Name:TAPPY
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:CO
Mailing Address - Zip Code:80754-0086
Mailing Address - Country:US
Mailing Address - Phone:970-313-7909
Mailing Address - Fax:
Practice Address - Street 1:702 W DRAKE RD BLDG E STE A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5557
Practice Address - Country:US
Practice Address - Phone:970-416-8342
Practice Address - Fax:970-416-8344
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC526858Medicare ID - Type Unspecified