Organization
MARATHON HEALTH, LLC
Active
Parent organization
MARATHON HEALTH, LLC
Other names
OC Tanner Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARATHON HEALTH, LLC
Authorized official
JERRY FORD (CEO)
(802) 857-0400
Entity
Organization
Contact information
Practice address
1865 S MAIN ST STE 12, SALT LAKE CITY, UT 84115-2090
(801) 657-5580
Mailing address
PO BOX 5, WINOOSKI, VT 05404-0005
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/30/2019
Last updated
02/19/2021
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