Provider Demographics
NPI:1497186282
Name:OBLEPIAS, MARICEL
Entity Type:Individual
Prefix:
First Name:MARICEL
Middle Name:
Last Name:OBLEPIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 KEYS CT
Mailing Address - Street 2:APT 7
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-6445
Mailing Address - Country:US
Mailing Address - Phone:252-916-0514
Mailing Address - Fax:
Practice Address - Street 1:1000 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-4017
Practice Address - Country:US
Practice Address - Phone:252-823-0401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP11253OtherNC PHYSICAL THERAPY LICENSE