Provider Demographics
NPI:1437541547
Name:LAROCCO, MARCIA CLINE (DPT)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:CLINE
Last Name:LAROCCO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:CLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5710 OLEANDER DR
Mailing Address - Street 2:STE 211
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4722
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:1632 WEST BROADWAY ANENUE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-5600
Practice Address - Country:US
Practice Address - Phone:865-984-1996
Practice Address - Fax:865-984-1997
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist