Provider Demographics
NPI:1285010124
Name:MARZIAZ, MANDY (DC)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:
Last Name:MARZIAZ
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 1:4960 YATES CT
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5618
Mailing Address - Country:US
Mailing Address - Phone:971-271-2459
Mailing Address - Fax:
Practice Address - Street 1:400 E SIMPSON ST STE G8
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2350
Practice Address - Country:US
Practice Address - Phone:720-749-6904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7702111N00000X
COCHR.0007702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor