Maxham, Marissa Lynnae

Maxham, Marissa Lynnae is an individual health care provider with primary practice located at 701 Shadwell Ave , Flora IL 62839-2310. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is her primary health care specialty. Maxham, Marissa Lynnae can be contacted via phone (618) 662-8361.

Contact Information

Primary practice address
701 Shadwell Ave Flora IL 62839-2310
Phone: (618) 662-8361
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 2081H0002X 160.008997 Illinois
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 160008997 Illinois

Profile Details

NPI number 1205405859
LBN Legal business name Maxham, Marissa Lynnae
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2021
Last updated Jun 18th, 2021 - about 4 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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