Provider Demographics
NPI:1417390733
Name:HOOVER, MARIANNE (LAC MAC)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:HOOVER
Suffix:
Gender:F
Credentials:LAC MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 GREENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1023
Mailing Address - Country:US
Mailing Address - Phone:215-630-5324
Mailing Address - Fax:
Practice Address - Street 1:131 S BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2803
Practice Address - Country:US
Practice Address - Phone:215-630-5324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001060171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist