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Individual
MR. MARK MARSHALL
Active
Individual
MR. MARK MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501019021
MI
2255A2300X
Athletic Trainer
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C80607
BCBS
MI
Enumeration date
01/08/2007
Last updated
02/10/2025
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