Provider Demographics
NPI:1235301789
Name:MACY, MARION (PT)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:MACY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 BLACK OAK DR # 1063
Mailing Address - Street 2:
Mailing Address - City:SAPPHIRE
Mailing Address - State:NC
Mailing Address - Zip Code:28774-7737
Mailing Address - Country:US
Mailing Address - Phone:828-507-4605
Mailing Address - Fax:828-214-5581
Practice Address - Street 1:1046 BLACK OAK DR # 1063
Practice Address - Street 2:
Practice Address - City:SAPPHIRE
Practice Address - State:NC
Practice Address - Zip Code:28774-7737
Practice Address - Country:US
Practice Address - Phone:828-507-4605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
FLPTA17476225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant