Provider Demographics
NPI:1417308438
Name:MARX, MARTIN JOHN (LMT)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:JOHN
Last Name:MARX
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 1:1073 OTTO RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-0406
Mailing Address - Country:US
Mailing Address - Phone:702-331-5330
Mailing Address - Fax:
Practice Address - Street 1:1073 OTTO RIDGE CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-0406
Practice Address - Country:US
Practice Address - Phone:702-331-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7412225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist