Provider Demographics
NPI:1760624480
Name:MARKS, PAUL R (ACUPUNCTURE)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:R
Last Name:MARKS
Suffix:
Gender:M
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FOREST FALLS DR STOP 3
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6936
Mailing Address - Country:US
Mailing Address - Phone:207-846-6464
Mailing Address - Fax:
Practice Address - Street 1:10 FOREST FALLS DR STOP 3
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6936
Practice Address - Country:US
Practice Address - Phone:207-846-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEA07171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist