Provider Demographics
NPI:1205122256
Name:VIOCK, MARCIE (LMT)
Entity type:Individual
Prefix:
First Name:MARCIE
Middle Name:
Last Name:VIOCK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MARCIE
Other - Middle Name:
Other - Last Name:JASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:242 E MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1246
Mailing Address - Country:US
Mailing Address - Phone:330-345-4440
Mailing Address - Fax:330-345-9335
Practice Address - Street 1:242 E MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1246
Practice Address - Country:US
Practice Address - Phone:330-345-4440
Practice Address - Fax:330-345-9335
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33014902HK225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist