Individual
MR. JASON MICHAEL MARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 S RALEIGH ST, MARTINSBURG, WV 25401-2642
(304) 262-9831
Mailing address
520 S RALEIGH ST, MARTINSBURG, WV 25401-2642
(240) 527-4941
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
23-911
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23-911
—
WV
Enumeration date
02/28/2023
Last updated
02/28/2023
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