Provider Demographics
NPI:1346867934
Name:BATSON, MARCUS A (LMT, MMP)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:A
Last Name:BATSON
Suffix:
Gender:M
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2784 GRASSMOOR LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5008
Mailing Address - Country:US
Mailing Address - Phone:407-860-2957
Mailing Address - Fax:
Practice Address - Street 1:2784 GRASSMOOR LOOP
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-5008
Practice Address - Country:US
Practice Address - Phone:407-860-2957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA87355225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist