Healthcare Provider Details

I. General information

NPI: 1982006466
Provider Name (Legal Business Name): MARKA JEAN SALSBERRY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARK JEAN GEHRIG P.T.

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 PARSONS AVE
COLUMBUS OH
43207-1933
US

IV. Provider business mailing address

1800 WATERMARK DR SUITE 420
COLUMBUS OH
43215-1048
US

V. Phone/Fax

Practice location:
  • Phone: 614-586-4159
  • Fax: 614-586-4252
Mailing address:
  • Phone: 614-645-5500
  • Fax: 614-645-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.010832
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: