Healthcare Provider Details

I. General information

NPI: 1093718231
Provider Name (Legal Business Name): MARION ANCILLARY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 DELAWARE AVE
MARION OH
43302-6416
US

IV. Provider business mailing address

PO BOX 1827
MARION OH
43301-1827
US

V. Phone/Fax

Practice location:
  • Phone: 740-383-8022
  • Fax: 740-383-7942
Mailing address:
  • Phone: 740-383-8022
  • Fax: 740-383-7942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number257689
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code246Q00000X
TaxonomyPathology Specialist/Technologist
License Number35057879
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License NumberRCP0800
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT003405
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberLO.10
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code225B00000X
TaxonomyPulmonary Function Technologist
License NumberRCP.0800
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.002441
License Number StateOH
# 8
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number2239705
License Number StateOH
# 9
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number4326110001
License Number StateOH
# 10
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateOH

VIII. Authorized Official

Name: DAVID PAUL MILLER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-383-7922