Provider Demographics
NPI:1093757775
Name:LINXWILER, MARCY L (PT)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:L
Last Name:LINXWILER
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 1:12505 HOMEPORT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MAUREPAS
Mailing Address - State:LA
Mailing Address - Zip Code:70449-3045
Mailing Address - Country:US
Mailing Address - Phone:225-348-2257
Mailing Address - Fax:225-675-3647
Practice Address - Street 1:12505 HOMEPORT DR
Practice Address - Street 2:SUITE A
Practice Address - City:MAUREPAS
Practice Address - State:LA
Practice Address - Zip Code:70449-3045
Practice Address - Country:US
Practice Address - Phone:225-348-2257
Practice Address - Fax:225-675-3647
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT06663225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist