Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 05010061A | IN |
N | 225100000X | Physical Therapist | 5501014729 | MI |
Y | 225100000X | Physical Therapist | PT37557 | CA |
NPI | 1003127176 |
---|---|
Provider Name | Ketki P Marathe |
First Address | Union City, CA 94587-1507 |
Second Address | Union City, CA 94587-1507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 11/02/2022 |