Provider Demographics
NPI:1558399246
Name:MARQUEZ, JHOANNA RAE (PT)
Entity Type:Individual
Prefix:
First Name:JHOANNA RAE
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 MOHICAN DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8281
Mailing Address - Country:US
Mailing Address - Phone:610-914-8294
Mailing Address - Fax:
Practice Address - Street 1:788 MOHICAN DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8281
Practice Address - Country:US
Practice Address - Phone:610-914-8294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01107600225100000X
PAPT018457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist