Provider Demographics
NPI:1427353689
Name:FROMOND, MARCEL CHRISTIAN
Entity type:Individual
Prefix:
First Name:MARCEL
Middle Name:CHRISTIAN
Last Name:FROMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 CAROLINA COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-6000
Mailing Address - Country:US
Mailing Address - Phone:704-249-2015
Mailing Address - Fax:
Practice Address - Street 1:6520 CAROLINA COMMONS DR
Practice Address - Street 2:
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-6000
Practice Address - Country:US
Practice Address - Phone:704-249-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6442225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist