Provider Demographics
NPI:1265747950
Name:PAPE, MARCY MANES (MPT, CLT, CBIS)
Entity type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:MANES
Last Name:PAPE
Suffix:
Gender:F
Credentials:MPT, CLT, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NATIONAL INTREPID CENTER OF EXCELLENCE
Mailing Address - Street 2:8901 WISCONSIN AVE.
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:301-319-3740
Mailing Address - Fax:
Practice Address - Street 1:NATIONAL INTREPID CENTER OF EXCELLENCE
Practice Address - Street 2:8901 WISCONSIN AVE.
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-319-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015123174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist