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General NPI Number Information
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NPI Number | 1174980510
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Entity Type | Individual
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Provider Name | KATRINA MARSHALL M.S., ATC, CSCS
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Gender | Female
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 108 RAVINE PKWY 117 ALUMNI FIELD HOUSE
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City | ONEONTA
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State | NY
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Zip | 13820-2685
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Country | US
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Telephone | 607-436-3580
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Fax |
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Provider Business Mailing Address
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Address Line | 27 CROFT RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-2645
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Country | US
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Telephone | 315-527-5796
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001921
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License Number State | NY
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