MEDICARE: MARCHELLA SCOTT LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MT-7386	CO

General Provider Information

NPI Number	:	1730316258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCHELLA SCOTT LMT

Provider Business Mailing Address
First Line	:	910 SANTA FE DR
Second Line	:	#19
City	:	DENVER
State	:	CO
Zip	:	80204-3975
Country	:	US
Telephone Number	:	720-309-7904
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 SANTA FE DR
Second Line	:	#19
City	:	DENVER
State	:	CO
Zip	:	80204-3975
Country	:	US
Telephone Number	:	720-309-7904
Fax Number	:	719-362-4203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	10/14/2011

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Directions to “ MARCHELLA SCOTT LMT” Practice Location

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