Provider Demographics
NPI:1356448518
Name:WARBY MARSH, GWENDOLYN IONE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:GWENDOLYN
Middle Name:IONE
Last Name:WARBY MARSH
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 E CHIPPEWA ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-1742
Mailing Address - Country:US
Mailing Address - Phone:989-317-4455
Mailing Address - Fax:989-317-4457
Practice Address - Street 1:608 E CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-1742
Practice Address - Country:US
Practice Address - Phone:989-317-4455
Practice Address - Fax:989-317-4457
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009392225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist