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Individual
MARCUS SHANNON KING
Active
Individual
MARCUS SHANNON KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT ATC LAT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2745
MS
2255A2300X
Athletic Trainer
AT0383
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125663
—
MS
01
—
DC7950
MEDICARE RAILROAD GROUP
GA
01
—
P00190587
MEDICARE RAILROAD PIN
GA
Enumeration date
06/14/2006
Last updated
01/09/2025
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