Provider Demographics
NPI:1487851622
Name:CARTY, MARCIA RENA (DI)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:RENA
Last Name:CARTY
Suffix:
Gender:F
Credentials:DI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 61 BOX 550
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465-9173
Mailing Address - Country:US
Mailing Address - Phone:606-349-2894
Mailing Address - Fax:606-349-2894
Practice Address - Street 1:HC 61 BOX 550
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-9173
Practice Address - Country:US
Practice Address - Phone:606-349-2894
Practice Address - Fax:606-349-2894
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist