Individual
MR. BLAINE MARBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
709 W 5TH ST, BONHAM, TX 75418-4209
(903) 583-8551
Mailing address
709 W 5TH, BONHAM, TX 75418
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2036366
TX
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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