Provider Demographics
NPI:1386903615
Name:MARCUS, VELNEICE
Entity type:Individual
Prefix:
First Name:VELNEICE
Middle Name:
Last Name:MARCUS
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 1:4480 SIRIUS AVE
Mailing Address - Street 2:APT 264
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7323
Mailing Address - Country:US
Mailing Address - Phone:702-809-7981
Mailing Address - Fax:
Practice Address - Street 1:4480 SIRIUS AVE
Practice Address - Street 2:APT 264
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7323
Practice Address - Country:US
Practice Address - Phone:702-809-7981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner