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General NPI Number Information
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NPI Number | 1518283902
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Entity Type | Individual
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Provider Name | JEANNE E MARSHALL PT
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Gender | Female
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Dates
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Enumeration Date | 04/11/2010
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Last Update Date | 04/11/2010
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Provider Practice Location Address
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Address Line | 1506 GULLY RD
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City | WALL
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State | NJ
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Zip | 07719-4443
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Country | US
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Telephone | 732-681-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 BAY AVE
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City | POINT PLEASANT BORO
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State | NJ
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Zip | 08742-3012
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Country | US
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Telephone | 732-714-1760
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00180000
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License Number State | NJ
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