Healthcare Provider Details

I. General information

NPI: 1144272782
Provider Name (Legal Business Name): MARCIE MARIE CHASE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST DEPARTMENT 120
DENVER CO
80220-3808
US

IV. Provider business mailing address

8466 S CARR ST
LITTLETON CO
80128-6225
US

V. Phone/Fax

Practice location:
  • Phone: 303-393-4674
  • Fax: 303-393-5003
Mailing address:
  • Phone: 303-904-8576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number706522
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: