Provider Demographics
NPI:1154404473
Name:FERRY, MARCIA H
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:H
Last Name:FERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:H
Other - Last Name:FERRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT, NCMMT
Mailing Address - Street 1:4420 ALTAMA AVE
Mailing Address - Street 2:SUITE 40
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3020
Mailing Address - Country:US
Mailing Address - Phone:912-996-1737
Mailing Address - Fax:912-267-9900
Practice Address - Street 1:3224 WISTERIA AVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4331
Practice Address - Country:US
Practice Address - Phone:912-267-3639
Practice Address - Fax:912-267-9900
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 32343225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA 32343OtherMASSAGE THERAPY