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General NPI Number Information
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NPI Number | 1396606612
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Entity Type | Organization
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Legal Business Name | MARION LISENBY MSPT LLC
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 139 SHIP SHOAL WAY
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6544
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Country | US
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Telephone | 757-404-0440
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Fax | 757-524-4004
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Provider Business Mailing Address
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Address Line | 139 SHIP SHOAL WAY
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6544
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Country | US
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Telephone | 757-404-0440
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Fax | 757-524-4004
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MARION A LISENBY
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Credential | MSPT
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Telephone | 757-404-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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