Provider Demographics
NPI:1235365453
Name:MARSH CHIROPRACTIC & WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:MARSH CHIROPRACTIC & WELLNESS CENTER, LLC
Other - Org Name:MARSH FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-681-2222
Mailing Address - Street 1:424 HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-3915
Mailing Address - Country:US
Mailing Address - Phone:865-681-2222
Mailing Address - Fax:865-681-8821
Practice Address - Street 1:1080 HUNTERS CROSSING
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701
Practice Address - Country:US
Practice Address - Phone:865-681-2222
Practice Address - Fax:865-681-8821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3672965Medicare PIN