Provider Demographics
NPI:1154414753
Name:QUESENBERRY, MARSHA ADAMS
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:ADAMS
Last Name:QUESENBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:ADAMS
Other - Last Name:LACY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:149 FIFTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-1756
Mailing Address - Country:US
Mailing Address - Phone:717-263-5548
Mailing Address - Fax:
Practice Address - Street 1:1007 WAYNE AVENUE
Practice Address - Street 2:PTETC
Practice Address - City:CHAMBERBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-3810
Practice Address - Country:US
Practice Address - Phone:717-263-5147
Practice Address - Fax:717-263-3454
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001231E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist