Provider Demographics
NPI:1073112942
Name:CADOW, MARC (LMT)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:CADOW
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 CARROLLTON AVE APT E
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2355
Mailing Address - Country:US
Mailing Address - Phone:504-982-1166
Mailing Address - Fax:
Practice Address - Street 1:1041 CARROLLTON AVE APT E
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2355
Practice Address - Country:US
Practice Address - Phone:504-982-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8412225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist