Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARISSA LYNNAE MAXHAM, PTA
ActiveMARISSA LYNNAE MAXHAM, PTA is a Pain Medicine (PM&R) healthcare provider located in FLORA, Illinois. NPI 1205405859 is currently active in the NPPES registry. Verify at CMS.
Pain Medicine (PM&R) · FLORA, IL
Registration Details
- NPI Number
- 1205405859
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 18, 2021 (4.9730193810731 yrs)
- Last Updated
- Jun 18, 2021
- Licenses
-
160.008997 (IL)160008997 (IL)
Practice Information
- Address
-
701 SHADWELL AVEFLORA, IL, 628392310Browse IL providers · Browse ZIP 62839
- Phone
- 6186628361
- Primary Specialty
-
Pain Medicine (PM&R)
2081P2900X
- Additional Specialty
- Pain Medicine (PM&R)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.