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General NPI Number Information
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NPI Number | 1548244924
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Entity Type | Individual
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Provider Name | MARC A PIQUET
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2020 BORST AVE SUITE 2
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City | CENTRALIA
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State | WA
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Zip | 98531
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Country | US
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Telephone | 360-807-0577
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Fax | 360-807-0574
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Provider Business Mailing Address
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Address Line | PO BOX 1338
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City | CENTRALIA
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State | WA
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Zip | 98531
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Country | US
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Telephone | 360-807-0577
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Fax | 360-807-0574
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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 | PT00008819
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License Number State | WA
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