Healthcare Provider Details

I. General information

NPI: 1457130999
Provider Name (Legal Business Name): AUDREY CATHERINE MARZEC PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/25/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 COLLEGE AVE
COLUMBUS OH
43209-2827
US

IV. Provider business mailing address

1032 ELCLIFF DR
WESTERVILLE OH
43081-1962
US

V. Phone/Fax

Practice location:
  • Phone: 614-231-4900
  • Fax:
Mailing address:
  • Phone: 614-264-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT020740
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: