Provider Demographics
NPI:1760157762
Name:MARATHON HEALTH LLC
Entity Type:Organization
Organization Name:MARATHON HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-857-0400
Mailing Address - Street 1:20 WINOOSKI FALLS WAY
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2228
Mailing Address - Country:US
Mailing Address - Phone:802-857-0400
Mailing Address - Fax:
Practice Address - Street 1:3300 FOREST HILL BLVD BLDG E
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5813
Practice Address - Country:US
Practice Address - Phone:561-437-6584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARATHON HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty