Provider Demographics
NPI:1457700270
Name:BOTHWELL STRICKLAND, MARJORIE T
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:T
Last Name:BOTHWELL STRICKLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 CAWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-1317
Mailing Address - Country:US
Mailing Address - Phone:734-352-7177
Mailing Address - Fax:
Practice Address - Street 1:808 CAWOOD ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1317
Practice Address - Country:US
Practice Address - Phone:734-352-7177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other