Provider Demographics
NPI:1326796350
Name:KINSEY, MARSHA L (MEDICAL MASSAGE)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:L
Last Name:KINSEY
Suffix:
Gender:F
Credentials:MEDICAL MASSAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1032
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-1032
Mailing Address - Country:US
Mailing Address - Phone:181-765-7677
Mailing Address - Fax:
Practice Address - Street 1:775 FM 1187 E
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4346
Practice Address - Country:US
Practice Address - Phone:817-657-6776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMTO26994225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist