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NPI Code Detail

MEDICARE: DR. KATIE LYNN MARCOUX PT, DPT

MEDICARE:  DR. KATIE LYNN MARCOUX  PT, DPT
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 TherapistPT28367FL

General Provider Information

NPI Number : 1922430230
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATIE LYNN MARCOUX PT, DPT
Provider Business Mailing Address
First Line : 3502 JENKS AVE APT 4200
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-0412
Country : US
Telephone Number : 850-974-0332
Fax Number :
Provider Business Practice Location Address
First Line : 1695 MAIN ST
Second Line :
City : CHIPLEY
State : FL
Zip : 32428-5992
Country : US
Telephone Number : 850-638-3387
Fax Number : 850-415-1967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2013
Last Update Date : 08/09/2013

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Directions to “ DR. KATIE LYNN MARCOUX PT, DPT” Practice Location

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