Provider Demographics
NPI:1992786446
Name:MACRI, MARK ANTHONY (PT DPT MS OCS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANTHONY
Last Name:MACRI
Suffix:
Gender:M
Credentials:PT DPT MS OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51687 NATIONAL RD E
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9304
Mailing Address - Country:US
Mailing Address - Phone:740-695-9868
Mailing Address - Fax:740-695-3385
Practice Address - Street 1:51687 NATIONAL RD E
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9304
Practice Address - Country:US
Practice Address - Phone:740-695-9868
Practice Address - Fax:740-695-3385
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2324247Medicaid
R72516Medicare UPIN
OH2324247Medicaid