Provider Demographics
NPI:1386194678
Name:MACLIN, MARCUS JAMES (COTA)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:JAMES
Last Name:MACLIN
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 PATTY CV
Mailing Address - Street 2:
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086-2446
Mailing Address - Country:US
Mailing Address - Phone:615-397-9051
Mailing Address - Fax:
Practice Address - Street 1:500 ELMINGTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2513
Practice Address - Country:US
Practice Address - Phone:615-292-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2721224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant