Individual
GERALD JAY MARQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
13420 BRIAR DR STE C, LEAWOOD, KS 66209
(913) 484-7632
(913) 808-5460
Mailing address
13420 BRIAR DR STE C, LEAWOOD, KS 66209-3411
(913) 484-7632
(913) 808-5460
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
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