Marquis Everett Bourne
Occupational Therapist, Physical Rehabilitation in Philadelphia, PA. Individual provider (NPI-1).
NPI number1386404192
StatusActive
Last updated in NPPESMar 20, 2024
Details
- NPI
- 1386404192
- Entity type
- Individual (NPI-1)
- Name
- Marquis Everett Bourne
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 20, 2024
- Certification date
- Mar 20, 2024
- Last updated
- Mar 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XP0019X | Occupational Therapist, Physical Rehabilitation | OP007808 | PA | Yes |
Practice location
5842 Florence AvePhiladelphia, PA 19143-4530
Phone 215-546-5960
Mailing address
1526 Lombard StPhiladelphia, PA 19146-1625
Phone 215-546-5960
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