Provider Demographics
NPI:1104223387
Name:MARKLEY, WANDA JEAN
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:JEAN
Last Name:MARKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 NAZARETH PIKE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9414
Mailing Address - Country:US
Mailing Address - Phone:610-746-4332
Mailing Address - Fax:
Practice Address - Street 1:216 NAZARETH PIKE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9414
Practice Address - Country:US
Practice Address - Phone:610-746-4332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2014-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist