Individual
KELLY MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5481 SW 60TH ST, OCALA, FL 34474-7698
(352) 873-1122
(352) 873-6841
Mailing address
5481 SW 60TH ST, OCALA, FL 34474-7698
(352) 873-1122
(352) 873-6841
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21142
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA21142
PTA LICENSE NUMBER
FL
Enumeration date
02/22/2008
Last updated
09/30/2008
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