Individual
BRENDA L MARCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2240 5TH AVE, HUNTINGTON, WV 25703-1239
(304) 525-4445
(304) 529-7449
Mailing address
2240 5TH AVE, HUNTINGTON, WV 25703-1239
(304) 525-4445
(304) 529-7449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1751
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720275
MOUNTAIN STATE BCBS
WV
05
—
2527608
—
OH
05
—
3810001064
—
WV
01
—
7403698
AETNA
—
01
—
P00156224
RR MEDICARE
—
Enumeration date
03/28/2006
Last updated
04/17/2008
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