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General NPI Number Information
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NPI Number | 1699825422
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Entity Type | Individual
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Provider Name | PAUL A. MARINO P.T.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 1809 CANTON RD SUITE 600
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City | MARIETTA
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State | GA
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Zip | 30066-6343
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Country | US
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Telephone | 678-213-1560
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Fax | 678-213-1705
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Provider Business Mailing Address
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Address Line | 736 JOHNSON FERRY RD SUITE A-12
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City | MARIETTA
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State | GA
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Zip | 30068-4379
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Country | US
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Telephone | 770-321-4720
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Fax | 770-579-7060
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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 | PT003365
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT003365
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License Number State | GA
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