Provider Demographics
NPI:1144804881
Name:MARATHON PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:MARATHON PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:302-690-5458
Mailing Address - Street 1:405 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:TALLEYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19803-5231
Mailing Address - Country:US
Mailing Address - Phone:302-690-5458
Mailing Address - Fax:
Practice Address - Street 1:405 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:TALLEYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19803-5231
Practice Address - Country:US
Practice Address - Phone:302-690-5458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy