Provider Demographics
NPI:1356754279
Name:MARQUEZ, JOSHUA B (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:B
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 N LITCHFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7804
Mailing Address - Country:US
Mailing Address - Phone:623-935-5505
Mailing Address - Fax:623-935-5551
Practice Address - Street 1:8811 N 51ST AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4949
Practice Address - Country:US
Practice Address - Phone:623-915-2726
Practice Address - Fax:623-915-2728
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10926225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist