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General NPI Number Information
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NPI Number | 1881364644
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Entity Type | Individual
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Provider Name | MARJORIE MEDINA GUARIN PT, DPT, GCS
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Gender | Female
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 742 MIDDLE CREEK RD
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City | SEVIERVILLE
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State | TN
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Zip | 37862-5019
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Country | US
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Telephone | 865-446-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 273 RIVER VALLEY CIR SEVIERVILLE, TN
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City | SEVIERVILLE
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State | TN
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Zip | 37862-3347
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Country | US
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Telephone | 186-520-8362
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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