Individual
GAIL MARIETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
111716-240
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11171624001001
BLUE CROSS BLUE SHIELD
UT
01
—
5417
DMBA
UT
01
—
6400386
UNITED HEALTHCARE
UT
01
—
68948
PEHP
UT
01
—
870388269BR1
EDUCATORS MUTUAL
UT
01
—
9951986
CIGNA
UT
01
—
CJ9402
RAILROAD MEDICARE
UT
01
—
QM0000060955
ALTIUS
UT
Enumeration date
08/03/2005
Last updated
05/02/2008
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