| NPI | 1952827818 |
|---|---|
| Other Name | MARATHON HEALTH- CHG- BOCA |
| Entity Type | Organization |
| Authorized Contact | JERRY FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |