Individual
BLAINE MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 LAKE RD STE 500, LAKE JACKSON, TX 77566-4982
(979) 258-7228
Mailing address
12400 SHADOW CREEK PKWY APT 409, PEARLAND, TX 77584-7349
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1352837
TX
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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