Provider Demographics
NPI:1538407788
Name:PAYNE, MARGARET ANN (PT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:PAYNE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 BALSAM ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4401
Mailing Address - Country:US
Mailing Address - Phone:610-212-2858
Mailing Address - Fax:
Practice Address - Street 1:1750 N HUMBOLDT ST STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1130
Practice Address - Country:US
Practice Address - Phone:303-861-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0012039OtherMEDICARE