Healthcare Provider Details

I. General information

NPI: 1144125337
Provider Name (Legal Business Name): THE MARMON FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BROADWAY AVE N APT 502
ROCHESTER MN
55906-6012
US

IV. Provider business mailing address

401 BROADWAY AVE N APT 502
ROCHESTER MN
55906-6012
US

V. Phone/Fax

Practice location:
  • Phone: 612-380-7012
  • Fax:
Mailing address:
  • Phone: 612-380-7012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SONNY AIDEN MARMON
Title or Position: FOUNDER, CEO
Credential: CPHQ, CHFP, CLSSBB
Phone: 612-380-7012