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Individual

ELIZABETH L MARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T., PH.D.,D.P.T.

Contact information

Practice address
1760 MCCULLOCH BLVD N STE 200, LAKE HAVASU CITY, AZ 86403-6559
(285) 055-6919
Mailing address
1760 MCCULLOCH BLVD N STE 200, LAKE HAVASU CITY, AZ 86403-6559
(285) 055-6919

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05012355A
IN
225100000X
Physical Therapist
Primary
2641
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
172166
AZ
Enumeration date
07/06/2006
Last updated
09/09/2020
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