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General NPI Number Information
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NPI Number | 1568971885
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Entity Type | Individual
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Provider Name | TIFFANY MARSHALL DPT
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Gender | Female
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Dates
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Enumeration Date | 09/29/2017
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Last Update Date | 09/29/2017
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Provider Practice Location Address
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Address Line | NORTH AT UAP BONE & JOINT CENTER LOWER LEVEL 1725 NORTH 5TH STREET
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City | TERRE HAUTE
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State | IN
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Zip | 47804
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Country | US
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Telephone | 812-242-3062
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Fax |
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Provider Business Mailing Address
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Address Line | 12179 N BDALE RD
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City | KINGMAN
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State | IN
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Zip | 47952-7022
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Country | US
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Telephone | 765-397-3279
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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 | 05012510A
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License Number State | IN
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