Provider Demographics
NPI:1407022577
Name:YARBOROUGH, MARCY ANN (LMT)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:ANN
Last Name:YARBOROUGH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 BRENTFORD RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-5705
Mailing Address - Country:US
Mailing Address - Phone:941-376-3342
Mailing Address - Fax:941-371-8543
Practice Address - Street 1:7125 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-8957
Practice Address - Country:US
Practice Address - Phone:941-376-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 27733173C00000X
FLMA27733225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC2481OtherBLUE CROSS BLUE SHIELD