Provider Demographics
NPI:1245592666
Name:FELIX, MARC (ATR)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:FELIX
Suffix:
Gender:M
Credentials:ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3140
Mailing Address - Country:US
Mailing Address - Phone:207-542-1847
Mailing Address - Fax:
Practice Address - Street 1:91 ELM ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1906
Practice Address - Country:US
Practice Address - Phone:207-542-1847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist