Individual
GERALD JAY MARQUETTE
Active
Individual
GERALD JAY MARQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-02826
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000140918
BLUE CROSS BLUE SHIELD
KS
01
—
11549331
CAQH
KS
Enumeration date
08/30/2006
Last updated
04/05/2021
Update your record
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