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
Fax:
Website:

Health care specialties

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982167789 NPPES
Georgia Other AT002377 GEORGIA SECRETARY OF STATE
Georgia Other BOC217903 GEORGIA SECRETARY OF STATE

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