Healthcare Provider Details

I. General information

NPI: 1487172508
Provider Name (Legal Business Name): NATALIE VICTORIA MARKLAND DPT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 STADIUM DR
BOULDER CO
80309-4182
US

IV. Provider business mailing address

5125 FOXGLOVE TRL
BROOMFIELD CO
80023-8760
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-9900
  • Fax: 303-315-9902
Mailing address:
  • Phone: 720-982-7894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.0001252
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0014952
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: