Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | TX | |
N | 225400000X | Rehabilitation Practitioner | IPHMNM8919 | |
N | 225700000X | Massage Therapist | TX | |
N | 226300000X | Kinesiotherapist | TX |
NPI | 1437810892 |
---|---|
Provider Name | Dr. Jenny Lynn Marchuk |
First Address | Irving, TX 75039-4166 |
Second Address | Dallas, TX 75287-7303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2022 |
Last Update Date | 15/01/2022 |