Provider Demographics
NPI:1093024895
Name:RINCON CHIROPRACTIC, MARSHALL LUCK DC, INC.
Entity Type:Organization
Organization Name:RINCON CHIROPRACTIC, MARSHALL LUCK DC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-896-2225
Mailing Address - Street 1:101 HOWARD ST STE D
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-1616
Mailing Address - Country:US
Mailing Address - Phone:415-896-2225
Mailing Address - Fax:
Practice Address - Street 1:101 HOWARD ST STE D
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1616
Practice Address - Country:US
Practice Address - Phone:415-896-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23047111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty