Individual
CAROL RENEE MARCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 MIZE BRANCH RD, MANCHESTER, KY 40962-6632
(606) 598-4667
Mailing address
155 MIZE BRANCH RD, MANCHESTER, KY 40962-6632
(606) 598-4667
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KY-R1597
KY
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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