Individual
MARLON D CRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 ILLINOIS AVE, YOUNGSTOWN, OH 44505-2874
(440) 444-4226
Mailing address
120 ILLINOIS AVE, YOUNGSTOWN, OH 44505-2874
(440) 444-4226
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
RZ574107
OH
347C00000X
Private Vehicle
Primary
RZ574107
OH
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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