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Individual
MARJORIE WILSON DEANE
Active
Individual
MARJORIE WILSON DEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001731
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000028161
ANTHEM INDIV#-PIQUA
OH
01
—
000000189899
ANTHEM INDIV PIN#-LIMA
OH
01
—
000000298668
ANTHEM INDIV PIN#-SIDNEY
OH
05
—
2068873
—
OH
Enumeration date
12/08/2006
Last updated
07/09/2007
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