# MARLENE ELIZABETH COLBURN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1164705463
- **Gender:** F
- **Credential:** DPT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT4972 | MS | Yes |

## Other

- **Enumeration date:** 09/22/2011
- **Last updated:** 05/30/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 06929043 | — | MS |
| 01 | — | 9005774 | AETNA | MS |
| 01 | — | P01022232 | RAILROAD MEDICARE | MS |