Provider Demographics
NPI:1225596919
Name:MARSHALL, CAMI CYAN (ATC)
Entity Type:Individual
Prefix:
First Name:CAMI
Middle Name:CYAN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 SE LEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7345
Mailing Address - Country:US
Mailing Address - Phone:772-261-7048
Mailing Address - Fax:
Practice Address - Street 1:2812 SE LEIGH AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7345
Practice Address - Country:US
Practice Address - Phone:772-261-7048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program