Provider Demographics
NPI:1073561361
Name:TINSLEY, MARC JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:JOHN
Last Name:TINSLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3958 MONROEVILLE BLVD
Mailing Address - Street 2:#101
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2457
Mailing Address - Country:US
Mailing Address - Phone:412-373-1030
Mailing Address - Fax:412-373-7395
Practice Address - Street 1:3958 MONROEVILLE BLVD
Practice Address - Street 2:#101
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2457
Practice Address - Country:US
Practice Address - Phone:412-373-1030
Practice Address - Fax:412-373-7395
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005212L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA455674OtherBLUE CROSS / BLUE SHIELD
PA455674OtherBLUE CROSS / BLUE SHIELD