Individual
MRS. MARY LOU MARQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1980 ACUSHNET AVENUE, NEW BEDFORD, MA 02745
(508) 995-7855
(508) 995-7161
Mailing address
33 CLUB AVENUE, ACUSHNET, MA 02743
(508) 995-7855
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
4003564
MA
335E00000X
Prosthetic/Orthotic Supplier
Primary
4003564
MA
Other
Enumeration date
07/21/2008
Last updated
07/21/2008
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