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Individual

MARCUM RALPH RANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LP, LPT

Contact information

Practice address
7051 CYPRESS TER STE 108, FORT MYERS, FL 33907-8801
(239) 437-4010
Mailing address
7051 CYPRESS TER STE 108, FORT MYERS, FL 33907-8801
(239) 437-4010

Taxonomy

Speciality
Code
Description
License number
State
2251H1300X
Human Factors Physical Therapist
Primary
PT4272
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6695430001
MEDICARE
FL
Enumeration date
01/09/2013
Last updated
01/09/2013
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