Healthcare Provider Details

I. General information

NPI: 1720054703
Provider Name (Legal Business Name): SHERYL MARIE MARKLEY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 EAYRESTOWN RD LUMBERTON HOLLY OFFICE CENTER
LUMBERTON NJ
08048-3100
US

IV. Provider business mailing address

13 W MILLCREEK RD
EASTAMPTON NJ
08060-5307
US

V. Phone/Fax

Practice location:
  • Phone: 609-261-1468
  • Fax:
Mailing address:
  • Phone: 609-261-1638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00302400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: