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NPI Code Detail

MEDICARE: MRS. LISA DIANE MARSHALL PT

MEDICARE: MRS. LISA DIANE MARSHALL PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT-007852OH

General Provider Information

NPI Number : 1154532281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA DIANE MARSHALL PT
Provider Business Mailing Address
First Line : 2451 FAIRCHILD CIR NW
Second Line :
City : UNIONTOWN
State : OH
Zip : 44685-6630
Country : US
Telephone Number : 330-499-7174
Fax Number :
Provider Business Practice Location Address
First Line : 2821 WOODLAWN AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44708-1423
Country : US
Telephone Number : 330-479-4805
Fax Number : 330-479-4803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. LISA DIANE MARSHALL PT” Practice Location

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