| NPI | 1598180226 |
|---|---|
| Other Name | MARATHON HEALTH AT CARNIVAL |
| Entity Type | Organization |
| Authorized Contact | JERRY FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2014-03-05 |
| Last Update Date | 2014-03-05 |