MEDICARE: ERIN WHITMARSH

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	225100000X	Physical Therapist	PTT34665	FL
2	225100000X	Physical Therapist	PT61087248	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174189310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN WHITMARSH

Provider Business Mailing Address
First Line	:	4356 OLDE PINE LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4356 OLDE PINE LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-4718
Country	:	US
Telephone Number	:	425-486-7710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2019
Last Update Date	:	07/18/2023

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