Provider Demographics
NPI:1710109475
Name:HIGBY, MARIE A (PT)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:A
Last Name:HIGBY
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 1:6400 PINEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7745
Mailing Address - Country:US
Mailing Address - Phone:614-519-0059
Mailing Address - Fax:
Practice Address - Street 1:1105 SCHROCK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1146
Practice Address - Country:US
Practice Address - Phone:614-505-7633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0074642251X0800X
NY0125402251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3142094Medicaid
OH4309421Medicare PIN