Individual
MR. MARLON GODFREY BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHS
Contact information
Practice address
3125 RIDGE PIKE, EAGLEVILLE, PA 19403-5708
(610) 630-2111
(610) 630-4003
Mailing address
3125 RIDGE PIKE, EAGLEVILLE, PA 19403-5708
(610) 630-2111
(610) 630-4003
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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