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NPI Code Detail

MEDICARE: MARVIN CRAIN

MEDICARE:   MARVIN  CRAIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOTA.Z20325LA

General Provider Information

NPI Number : 1578835963
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARVIN CRAIN
Provider Business Mailing Address
First Line : 1488 FROST TOWER RD
Second Line :
City : WEST MONROE
State : LA
Zip : 71292-2325
Country : US
Telephone Number : 318-376-5221
Fax Number :
Provider Business Practice Location Address
First Line : 1488 FROST TOWER RD
Second Line :
City : WEST MONROE
State : LA
Zip : 71292-2325
Country : US
Telephone Number : 318-376-5221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2012
Last Update Date : 02/01/2012

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Directions to “ MARVIN CRAIN ” Practice Location

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