Basic Information
| Provider Information | |||||||||
| NPI: | 1457757841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POHLMAN | ||||||||
| FirstName: | MARISA | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 42680 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787040043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123262800 | ||||||||
| FaxNumber: | 5124416388 | ||||||||
| Practice Location | |||||||||
| Address1: | 11150 RESEARCH BLVD STE 212 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787595243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127948863 | ||||||||
| FaxNumber: | 5127950688 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2014 | ||||||||
| LastUpdateDate: | 01/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1251847 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.