Provider Demographics
NPI:1083438717
Name:SLAY, MARIAN R (PT)
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:R
Last Name:SLAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 PATCHEN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4310
Mailing Address - Country:US
Mailing Address - Phone:859-797-0306
Mailing Address - Fax:
Practice Address - Street 1:3970 W 24TH ST STE 108
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-9257
Practice Address - Country:US
Practice Address - Phone:928-783-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009236225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist