Healthcare Provider Details

I. General information

NPI: 1538407788
Provider Name (Legal Business Name): MARGARET ANN PAYNE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 N HUMBOLDT ST STE 101
DENVER CO
80218-1130
US

IV. Provider business mailing address

689 BALSAM ST
LAKEWOOD CO
80214-4401
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-0057
  • Fax:
Mailing address:
  • Phone: 610-212-2858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0012039
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: