Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT13285 | FL |
N | 2251G0304X | Physical Therapist - Geriatrics | PT13285 | FL |
NPI | 1124382411 |
---|---|
Provider Name | Mrs. Katja Marxen |
First Address | Jupiter, FL 33458-6910 |
Second Address | Jupiter, FL 33458-6910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2012 |
Last Update Date | 02/07/2012 |