Healthcare Provider Details

I. General information

NPI: 1558541607
Provider Name (Legal Business Name): DARRIN WRAY MARSH PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 EMERSON AVE
PARKERSBURG WV
26104-1217
US

IV. Provider business mailing address

4315 EMERSON AVE
PARKERSBURG WV
26104-1217
US

V. Phone/Fax

Practice location:
  • Phone: 304-428-8300
  • Fax: 304-428-5087
Mailing address:
  • Phone: 304-428-8300
  • Fax: 304-428-5087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number002435
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number002435
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: