Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 5501015913 | MI |
NPI | 1063767440 |
---|---|
Provider Name | Mrs. Lindsay Marie Marquardt |
First Address | Saginaw, MI 48602-4316 |
Second Address | Saginaw, MI 48602-4316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2012 |
Last Update Date | 09/03/2018 |