Healthcare Provider Details

I. General information

NPI: 1932063716
Provider Name (Legal Business Name): MARSO VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FORUM BLVD STE 7A371
COLUMBIA MO
65203-1938
US

IV. Provider business mailing address

1400 FORUM BLVD STE 7A371
COLUMBIA MO
65203-1938
US

V. Phone/Fax

Practice location:
  • Phone: 573-200-6024
  • Fax: 573-200-6024
Mailing address:
  • Phone: 573-200-6024
  • Fax: 573-200-6024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA MARSO
Title or Position: APRN
Credential: APRN
Phone: 573-200-6024