Organization
DR. MARBOURG AND ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBIN LIVELY MARBOURG O.D. (SECRETARY)
(205) 625-5520
Entity
Organization
Contact information
Practice address
308 6TH ST S, SUITE 105, ONEONTA, AL 35121-1846
(205) 625-5520
(205) 625-5522
Mailing address
PO BOX 40, ONEONTA, AL 35121-0001
(205) 625-5520
(205) 625-5522
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-712-TA-055
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104527
BLOCK VISION
AL
05
—
529803890
—
AL
Enumeration date
01/04/2007
Last updated
05/10/2008
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