Provider Demographics
NPI:1114048634
Name:MARZILLI CHIROPRACTIC CENTER, LTD.
Entity Type:Organization
Organization Name:MARZILLI CHIROPRACTIC CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARZILLI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:401-270-9595
Mailing Address - Street 1:1395 ATWOOD AVE
Mailing Address - Street 2:SUITE 108A
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-4929
Mailing Address - Country:US
Mailing Address - Phone:401-270-9595
Mailing Address - Fax:401-383-5155
Practice Address - Street 1:1395 ATWOOD AVE
Practice Address - Street 2:SUITE 108A
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-4929
Practice Address - Country:US
Practice Address - Phone:401-270-9595
Practice Address - Fax:401-383-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI405361OtherBLUE CHIP
RI31611-2OtherBLUE CROSS BLUE SHIELD
RI44-00485OtherUNITED HEALTHCARE
RI405361OtherBLUE CHIP