Provider Demographics
NPI:1265661334
Name:MARSH, JENNIFER S (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:MARSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:SCHRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3001 EDWARDS MILL RD
Mailing Address - Street 2:# 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:919-781-4060
Mailing Address - Fax:919-781-5246
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-781-4060
Practice Address - Fax:919-781-5246
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist