Individual
MR. MAX W MARION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
1725 ASHLEY CIR, SUITE 212, BOWLING GREEN, KY 42104-3337
(270) 782-0434
(270) 782-0564
Mailing address
1945 SCOTTSVILLE RD, B2 PMB137, BOWLING GREEN, KY 42104-3376
(270) 782-0434
(270) 782-0564
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SA272
KY
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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