Provider Demographics
NPI:1952646119
Name:SALISBURY, MARCIA R (RPTA)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:R
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:RPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3610
Mailing Address - Country:US
Mailing Address - Phone:918-951-0312
Mailing Address - Fax:
Practice Address - Street 1:1104 ROBIN RD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3610
Practice Address - Country:US
Practice Address - Phone:918-951-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK36225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant