Provider Demographics
NPI:1093797409
Name:MARINACCI, JOSEPH B (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:MARINACCI
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 1:3 STATION PLACE
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-6579
Mailing Address - Country:US
Mailing Address - Phone:304-757-7266
Mailing Address - Fax:304-757-9865
Practice Address - Street 1:3 STATION PLACE
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9480
Practice Address - Country:US
Practice Address - Phone:304-757-7266
Practice Address - Fax:304-757-9865
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-19
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004081Medicaid
WVV06807Medicare UPIN
WV3810004081Medicaid