Provider Demographics
NPI:1528340114
Name:MARSHALL, BARRY K (PT)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:K
Last Name:MARSHALL
Suffix:
Gender:M
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:PO BOX 819
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:NE
Mailing Address - Zip Code:69033-0819
Mailing Address - Country:US
Mailing Address - Phone:308-882-7111
Mailing Address - Fax:308-882-7341
Practice Address - Street 1:600 WEST 12TH ST.
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:NE
Practice Address - Zip Code:69033
Practice Address - Country:US
Practice Address - Phone:308-882-7111
Practice Address - Fax:308-882-7341
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist