Provider Demographics
NPI:1023132065
Name:MARLOWE, DAVID G JR (NCMMT, LMT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:MARLOWE
Suffix:JR
Gender:M
Credentials:NCMMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12921 CHIPPEWA RD
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-2160
Mailing Address - Country:US
Mailing Address - Phone:330-671-2976
Mailing Address - Fax:
Practice Address - Street 1:147 E AURORA RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2054
Practice Address - Country:US
Practice Address - Phone:330-671-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33012061225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist