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General NPI Number Information
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NPI Number | 1790477925
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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 | 05/25/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 2926 PIPER DR BLDG 13
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City | VERO BEACH
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State | FL
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Zip | 32960-1955
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Country | US
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Telephone | 772-253-2502
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Fax |
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Provider Business Mailing Address
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Address Line | 10 W MARKET ST STE 2900
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-2964
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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 | CEO
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Name | JEFF WELLS
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Credential | MD
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Telephone | 802-857-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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