Healthcare Provider Details

I. General information

NPI: 1255246476
Provider Name (Legal Business Name): COLLEEN THERESA FEARON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TIMBERLINE DR
MARIETTA OH
45750-9238
US

IV. Provider business mailing address

219 ASH RD
MARIETTA OH
45750-7952
US

V. Phone/Fax

Practice location:
  • Phone: 740-376-0535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7173
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: