Provider Demographics
NPI:1487946406
Name:WEBB, MARCELENE LOUISE (LAC, RN)
Entity type:Individual
Prefix:
First Name:MARCELENE
Middle Name:LOUISE
Last Name:WEBB
Suffix:
Gender:F
Credentials:LAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29664 CHATHAM WAY
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3405
Mailing Address - Country:US
Mailing Address - Phone:419-460-6779
Mailing Address - Fax:419-578-6918
Practice Address - Street 1:440 S REYNOLDS RD
Practice Address - Street 2:SUITE D
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-5900
Practice Address - Country:US
Practice Address - Phone:419-460-6779
Practice Address - Fax:419-578-6918
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000196171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist