Individual
MRS. DENNILLE MARIE MARBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
25 LIBERTY ST STE 5, BATAVIA, NY 14020-3246
(585) 343-1840
Mailing address
25 LIBERTY ST STE 5, BATAVIA, NY 14020-3246
(585) 343-1840
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
007610
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007610
PTA LICENSE NUMBER
NY
Enumeration date
02/24/2011
Last updated
06/20/2013
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