Individual
MARC ANDREW HOLDEREAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
4411 S ADAMS ST, MARION, IN 46953-5349
(765) 674-4455
(765) 674-3577
Mailing address
4411 S ADAMS ST, MARION, IN 46953-5349
(765) 674-4455
(765) 674-3577
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005616A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100124000
—
IN
01
—
129137500
US DEPARTMENT OF LABOR
IN
01
—
156540
MEDICARE
IN
Enumeration date
02/24/2015
Last updated
02/24/2015
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