Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2028926 | TX |
NPI | 1013111079 |
---|---|
Provider Name | Stephen Neil Marsh |
First Address | Milford, TX 76670-1140 |
Second Address | Corsicana, TX 75110-2412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |