Crystal Mary Marsh, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11280 Issued in MA

Practice address

34 Pearly LN
Gardner, MA 01440-1736

Phone

(978) 632-1230

Fax

(978) 632-4513

NPI assigned

Dec 12, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Crystal Mary Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1326316837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PEARLY LN",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401736",
            "telephone_number": "978-632-1230",
            "fax_number": "978-632-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PEARLY LN",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401736",
            "telephone_number": "978-632-1230",
            "fax_number": "978-632-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "CRYSTAL",
        "middle_name": "MARY",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "CLARK",
            "middle_name": "MARY",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Maresca, M. ED
• Mark Brooks, PH.D., Inc.
• Andrew Markwith, M.D.
• Jay Eric Marrero
• Jo Ellen Papaleo Marro, LMHC
• Jonathan Marshall
• Josephine Marshall, BA
• Kellie Martel
• Keara Laura Martin, PA-C
• Krystin Marie Martin, M.S. OTR/L

• Physical Therapist in Gardner, MA
• Providers in Gardner, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.