Provider Demographics
NPI:1528158367
Name:MARSHAL, ROBIN LEIGH (PTA)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LEIGH
Last Name:MARSHAL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:903 OCEAN BLVD
Mailing Address - Street 2:APT B
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-4656
Mailing Address - Country:US
Mailing Address - Phone:912-638-2970
Mailing Address - Fax:912-638-1584
Practice Address - Street 1:2601A DEMERE RD
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-1614
Practice Address - Country:US
Practice Address - Phone:912-634-9945
Practice Address - Fax:912-638-1584
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001952225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant