# MARATHON HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARATHON HEALTH LLC
- **Other names:** Fabri Kal and Schupan Health Center, Fabrikal Schupan Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104318369
- **Legal business name:** MARATHON HEALTH LLC
- **Authorized official:** JERRY FORD (CEO)
- **Authorized official phone:** (802) 857-0400

## Contact information

- **Practice address:** 3520 COVINGTON RD, KALAMAZOO, MI 49001
- **Practice address phone:** (802) 857-0400
- **Mailing address:** 20 WINOOSKI FALLS WAY STE 400, WINOOSKI, VT 05404-2239
- **Mailing address phone:** (802) 857-0434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2018
- **Last updated:** 06/16/2018