Individual
MS. MARY J MARINO
Active
Individual
MS. MARY J MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
260
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3652981
—
TN
01
—
84299
BLUE CROSS
TN
01
—
CH4394
MEDICARE-RAILROAD GROUP ID
TN
Enumeration date
05/16/2006
Last updated
06/24/2010
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