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Individual

MICHAEL BRYANT MARCUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1465 MORRIS LANE BLUE RUN RD # A, LUCASVILLE, OH 45648-8701
(740) 259-9531
(740) 259-9531
Mailing address
1465 MORRIS LANE BLUE RUN RD # A, LUCASVILLE, OH 45648-8701
(740) 259-9531
(740) 259-9531

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
VL73038714
OH
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2229743
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2229743
OH
Enumeration date
06/03/2007
Last updated
09/11/2025
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