Provider Demographics
NPI:1598386401
Name:MARSHALL, KAREN M (LMT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 STRATFORD CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5843
Mailing Address - Country:US
Mailing Address - Phone:239-450-3929
Mailing Address - Fax:
Practice Address - Street 1:4632 VINCENNES BLVD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9105
Practice Address - Country:US
Practice Address - Phone:239-542-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM86721225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty