Provider Demographics
NPI:1114441581
Name:SALVADOR, MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3116
Mailing Address - Country:US
Mailing Address - Phone:312-225-3119
Mailing Address - Fax:
Practice Address - Street 1:14310 LAYHILL VALLEY CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1906
Practice Address - Country:US
Practice Address - Phone:240-461-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist