Individual
MISS MARISSA QUIJANO MEDLEY
Active
Individual
MISS MARISSA QUIJANO MEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7006
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223879
—
AZ
01
—
P00625153
RAILROAD MEDICARE
AZ
Enumeration date
05/19/2006
Last updated
03/15/2010
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