Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 003790-1 | NY |
Y | 225100000X | Physical Therapist | 1899 | CO |
N | 225100000X | Physical Therapist | PT 16683 | CA |
NPI | 1003068438 |
---|---|
Provider Name | Mr. Peter L Marshall |
First Address | Telluride, CO 81435-1303 |
Second Address | Telluride, CO 81435-1303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2008 |
Last Update Date | 16/10/2008 |