Provider Demographics
NPI:1013061118
Name:OSBORNE, MARCUS WHITFIELD (LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:WHITFIELD
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1129 WINDY HILL DR NW
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-9095
Mailing Address - Country:US
Mailing Address - Phone:828-326-2272
Mailing Address - Fax:828-322-6559
Practice Address - Street 1:810 FAIRGROVE CHURCH RD
Practice Address - Street 2:CVMC-CENTER FOR REHABILITATION
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9617
Practice Address - Country:US
Practice Address - Phone:828-326-2272
Practice Address - Fax:828-322-6559
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer