Provider Demographics
NPI:1063634103
Name:SEXTON, MARIANNA LE (MPT)
Entity Type:Individual
Prefix:MISS
First Name:MARIANNA
Middle Name:LE
Last Name:SEXTON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 TOWNSHIP ROAD 1216
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8644
Mailing Address - Country:US
Mailing Address - Phone:740-886-0858
Mailing Address - Fax:740-886-7854
Practice Address - Street 1:1 BRADLEY FOSTER DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-9448
Practice Address - Country:US
Practice Address - Phone:304-525-3561
Practice Address - Fax:304-525-3561
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist