Provider Demographics
NPI:1336473016
Name:MARION CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:MARION CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOACHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-751-6800
Mailing Address - Street 1:1036 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5537
Mailing Address - Country:US
Mailing Address - Phone:740-751-6800
Mailing Address - Fax:740-751-6802
Practice Address - Street 1:1036 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5537
Practice Address - Country:US
Practice Address - Phone:740-751-6800
Practice Address - Fax:740-751-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3001487OtherMEDICAID GROUP
OH9385551OtherMEDICARE SOLE OWNED ORG. PTAN
OH2337975Medicaid
U92671Medicare UPIN