# MARATHON HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARATHON HEALTH LLC
- **Other names:** Laitram Hanover Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1235760653
- **Legal business name:** MARATHON HEALTH LLC
- **Authorized official:** JERR FORD (CEO)
- **Authorized official phone:** (802) 857-0400

## Contact information

- **Practice address:** 7157 RIDGE RD, HANOVER, MD 21076-1425
- **Practice address phone:** (443) 951-4804
- **Mailing address:** PO BOX 5, WINOOSKI, VT 05404-0005

## Taxonomy

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

## Other

- **Enumeration date:** 02/04/2020
- **Last updated:** 02/04/2020