Provider Demographics
NPI:1982006466
Name:SALSBERRY, MARKA JEAN (PT)
Entity Type:Individual
Prefix:
First Name:MARKA
Middle Name:JEAN
Last Name:SALSBERRY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARK
Other - Middle Name:JEAN
Other - Last Name:GEHRIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1800 WATERMARK DR
Mailing Address - Street 2:SUITE 420
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1048
Mailing Address - Country:US
Mailing Address - Phone:614-645-5500
Mailing Address - Fax:614-645-5517
Practice Address - Street 1:1905 PARSONS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1933
Practice Address - Country:US
Practice Address - Phone:614-586-4159
Practice Address - Fax:614-586-4252
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.010832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0111431Medicaid
OH0111431Medicaid