Individual
MRS. INGRID A MARISIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
MACH RPC, MARTIN LOOP BUILDING 9224, FORT BENNING, GA 31905
(706) 544-2633
Mailing address
536 N VALDEZ CT APT B, FORT BENNING, GA 31905-7876
(706) 544-2633
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
284009
NY
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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