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General NPI Number Information
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NPI Number | 1215711379
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Entity Type | Individual
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Provider Name | MARKI TOMIKO FONG PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 4714 MILESTONE LN STE B
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City | CASTLE ROCK
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State | CO
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Zip | 80104-7908
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Country | US
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Telephone | 303-660-5349
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Fax | 303-660-5379
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Provider Business Mailing Address
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Address Line | 4714 MILESTONE LN STE B
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City | CASTLE ROCK
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State | CO
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Zip | 80104-7908
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Country | US
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Telephone | 303-660-5349
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Fax | 303-660-5379
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 1382469
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0020500
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License Number State | CO
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