Maiwelmal, Marissa

Maiwelmal, Marissa is an individual health care provider with primary practice located at 3801 County Road 3401 , Lone Oak TX 75453-4143. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Maiwelmal, Marissa can be contacted via phone (903) 456-5323.

Contact Information

Primary practice address
3801 County Road 3401 Lone Oak TX 75453-4143
Phone: (903) 456-5323
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2127201 Texas

Profile Details

NPI number 1962980938
LBN Legal business name Maiwelmal, Marissa
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2018
Last updated Aug 1st, 2018 - 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 1962980938 NPPES
Texas Other ZGP821864675 BLUE CROSS BLUE SHIELD

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