Provider Demographics
NPI:1124382411
Name:MARXEN, KATJA (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATJA
Middle Name:
Last Name:MARXEN
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 1:162 VIA VERACRUZ
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6910
Mailing Address - Country:US
Mailing Address - Phone:561-541-3106
Mailing Address - Fax:561-744-1325
Practice Address - Street 1:162 VIA VERACRUZ
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6910
Practice Address - Country:US
Practice Address - Phone:561-541-3106
Practice Address - Fax:561-744-1325
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13285225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics