| NPI | 1972051167 |
|---|---|
| Other Name | MARATHON HEALTH AT CHICO'S |
| Entity Type | Organization |
| Authorized Contact | JERRY FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |