Provider Demographics
NPI:1487092953
Name:RENFROW, MARION ELIZABETH (MSPT)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:ELIZABETH
Last Name:RENFROW
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MRS
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:RENFROW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:424 S KENDALL ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3406
Mailing Address - Country:US
Mailing Address - Phone:303-762-1791
Mailing Address - Fax:
Practice Address - Street 1:424 S KENDALL ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3406
Practice Address - Country:US
Practice Address - Phone:303-762-1791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6449225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist