Individual
MS. MARY E MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5881 W 16TH ST, GREELEY, CO 80634-2910
(970) 313-2775
(970) 350-2777
Mailing address
5881 W 16TH ST, GREELEY, CO 80634-2910
(970) 313-2775
(970) 350-2777
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
239129
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51558271
—
CO
01
—
P00944887
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
03/26/2007
Last updated
01/10/2012
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