Provider Demographics
NPI:1376973982
Name:MARKS, KERRI S (PT)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:S
Last Name:MARKS
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:PO BOX 50
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-0050
Mailing Address - Country:US
Mailing Address - Phone:740-892-3675
Mailing Address - Fax:740-892-9582
Practice Address - Street 1:8200 HAZELTON ETNA RD SW
Practice Address - Street 2:STE 300
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43062-9630
Practice Address - Country:US
Practice Address - Phone:740-892-3675
Practice Address - Fax:740-892-9582
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist