Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070.015635 | IL |
N | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1104032366 |
---|---|
Provider Name | Anna F Marshall |
First Address | Louisville, CO 80027-9429 |
Second Address | Louisville, CO 80027-9429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 17/03/2018 |