Individual
MARQUIS EDJUAN SCURLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RDN, LD
Contact information
Practice address
1150 DARLENE LN APT 293, EUGENE, OR 97401-1103
(601) 842-6748
Mailing address
1150 DARLENE LN APT 293, EUGENE, OR 97401-1103
(601) 842-6748
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-10191450
OR
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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