MEDICARE: TARA D MARSH, PT, DPT, LLC

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
1	2251P0200X	Pediatric Physical Therapist

General Provider Information

NPI Number	:	1164367124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARA D MARSH, PT, DPT, LLC

Provider Business Mailing Address
First Line	:	2385 LAWRENCEVILLE HWY STE A
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-3168
Country	:	US
Telephone Number	:	817-798-9314
Fax Number	:

Provider Business Practice Location Address
First Line	:	2385 LAWRENCEVILLE HWY STE A
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-3168
Country	:	US
Telephone Number	:	817-798-9314
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	TARA DAWN MARSH
Credential	:	PT,DPT
Telephone Number	:	470-563-8130

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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