Provider Demographics
NPI:1144462011
Name:MARX, COLLEEN JOY (LMT)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:JOY
Last Name:MARX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 COWPER CIR
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-7970
Mailing Address - Country:US
Mailing Address - Phone:716-447-0252
Mailing Address - Fax:
Practice Address - Street 1:7 COWPER CIR
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-7970
Practice Address - Country:US
Practice Address - Phone:716-447-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012267-1175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath