Underwood, Marcus A
Underwood, Marcus A is an sole proprietor health care provider with primary practice located at 123 Vinings Pkwy Se , Smyrna GA 30080-3863. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Underwood, Marcus A can be contacted via phone (678) 523-1547.Contact Information
Primary practice address
123 Vinings Pkwy Se
Smyrna GA 30080-3863
Phone: (678) 523-1547
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | AT002377 | Georgia |
Profile Details
| NPI number | 1982167789 |
|---|---|
| LBN Legal business name | Underwood, Marcus A |
| Credentials | LAT, ATC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 9th, 2019 |
| Last updated | Apr 9th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982167789 | NPPES |
| Georgia | Other | AT002377 | GEORGIA SECRETARY OF STATE |
| Georgia | Other | BOC217903 | GEORGIA SECRETARY OF STATE |
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