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General NPI Number Information
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NPI Number | 1710608070
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Entity Type | Organization
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Legal Business Name | MARATHON HEALTH, LLC
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 262 S 3800 W
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City | PROVO
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State | UT
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Zip | 84601-8204
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Country | US
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Telephone | 385-287-6528
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Fax |
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Provider Business Mailing Address
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Address Line | 20 WINOOSKI FALLS WAY STE 400
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City | WINOOSKI
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State | VT
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Zip | 05404-2239
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Country | US
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Telephone | 866-434-3255
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Fax |
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Authorized Official
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Title or Position | LOGISTICS
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Name | RHIANNON CHANDLER
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Credential |
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Telephone | 866-434-3255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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