Provider Demographics
NPI:1609425305
Name:MARSZALEK, REBECCA (ATC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MARSZALEK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MILTON ST
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-1718
Mailing Address - Country:US
Mailing Address - Phone:508-441-1615
Mailing Address - Fax:
Practice Address - Street 1:125 MILTON ST
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02748-1718
Practice Address - Country:US
Practice Address - Phone:508-441-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0061832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty