Provider Demographics
NPI:1528403201
Name:MARKLE, NATALIE ANN (PTA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:MARKLE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 INDIAN TRAIL FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-8580
Mailing Address - Country:US
Mailing Address - Phone:980-328-2504
Mailing Address - Fax:
Practice Address - Street 1:2700 MEMORIAL PARK DR
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-8481
Practice Address - Country:US
Practice Address - Phone:980-328-2504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2092689225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant