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NPI Code Detail

MEDICARE: BRENDA L MARCUM P.T.

MEDICARE: BRENDA L MARCUM P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1751WV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00156224OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3001720275OTHERWVMOUNTAIN STATE BCBS
47403698OTHERAETNA

General Provider Information

NPI Number : 1841251287
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA L MARCUM P.T.
Provider Business Mailing Address
First Line : 2240 5TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25703-1239
Country : US
Telephone Number : 304-525-4445
Fax Number : 304-529-7449
Provider Business Practice Location Address
First Line : 2240 5TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25703-1239
Country : US
Telephone Number : 304-525-4445
Fax Number : 304-529-7449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 04/17/2008

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Directions to “ BRENDA L MARCUM P.T.” Practice Location

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