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General NPI Number Information
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NPI Number | 1225181720
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Entity Type | Individual
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Provider Name | MARCUS MAIER
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 400 N. MORRIS ST.
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City | STOUGHTON
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State | WI
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Zip | 53589-1857
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Country | US
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Telephone | 608-873-9454
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Fax | 608-873-5748
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Provider Business Mailing Address
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Address Line | 1405 E. RD. 7
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City | EDGERTON
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State | WI
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Zip | 53534-9027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 977-019
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License Number State | WI
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