Individual
JEREMY MARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC,CSCS
Contact information
Practice address
60 AVERYVILLE LN, LAKE PLACID, NY 12946-3002
(734) 502-6031
Mailing address
60 AVERYVILLE LN, LAKE PLACID, NY 12946-3002
(734) 502-6031
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000082
MI
Other
Enumeration date
07/09/2007
Last updated
12/02/2022
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