Provider Demographics
NPI:1275869257
Name:MCARDLE, MARLA RENEE (DC)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:RENEE
Last Name:MCARDLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E MOREHEAD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2616
Mailing Address - Country:US
Mailing Address - Phone:704-334-3761
Mailing Address - Fax:704-334-3763
Practice Address - Street 1:500 E MOREHEAD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2616
Practice Address - Country:US
Practice Address - Phone:704-334-3761
Practice Address - Fax:704-334-3763
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor