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Individual

MR. LEE E MARVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MPA, CHE, ACHE, ACA

Contact information

Practice address
6741 TAYLOR CIR, MONTGOMERY, AL 36117-7786
(334) 277-4327
(334) 277-4348
Mailing address
6741 TAYLOR CIR, MONTGOMERY, AL 36117-7786
(334) 277-4327
(334) 277-4348

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2173
AL
225400000X
Rehabilitation Practitioner
2173
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515-37457
BLUE CROSS BLUE SHIELD
AL
Enumeration date
04/26/2007
Last updated
02/24/2017
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