Healthcare Provider Details

I. General information

NPI: 1285639989
Provider Name (Legal Business Name): MARQUIS HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4051 WHIPPLE AVE NW STE. A
CANTON OH
44718-2977
US

IV. Provider business mailing address

4051 WHIPPLE AVE NW STE. A
CANTON OH
44718-2977
US

V. Phone/Fax

Practice location:
  • Phone: 330-491-0550
  • Fax: 800-860-8832
Mailing address:
  • Phone: 330-491-0550
  • Fax: 800-860-8832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD SCOTT WORSTELL
Title or Position: OWNER/CEO
Credential:
Phone: 330-491-0550