Individual
MARLA J JACQUINOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
601 E 63RD ST STE 230, KANSAS CITY, MO 64110-3303
(816) 569-2802
Mailing address
601 E 63RD ST STE 230, KANSAS CITY, MO 64110-3303
(816) 569-2802
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-03521
KS
225100000X
Physical Therapist
Primary
2000167616
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T66000002
MEDICARE PTAN
KS
01
—
T66A00003
MEDICARE PTAN
MO
Enumeration date
06/11/2007
Last updated
04/09/2025
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