Provider Demographics
NPI:1548410152
Name:YOUNG, NATASHA MARIKO (PT)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:MARIKO
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:720 S. COLORADO BLVD
Mailing Address - Street 2:SUITE 220A
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1912
Mailing Address - Country:US
Mailing Address - Phone:303-214-0330
Mailing Address - Fax:303-214-0335
Practice Address - Street 1:1444 S. POTOMAC ST
Practice Address - Street 2:SUITE 210
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4509
Practice Address - Country:US
Practice Address - Phone:303-214-0330
Practice Address - Fax:303-214-0335
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2010-06-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC066615Medicare PIN