Provider Demographics
NPI:1366452997
Name:MARRAFFA, MARY JO (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY JO
Middle Name:
Last Name:MARRAFFA
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 1:317 CHARLESTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1205
Mailing Address - Country:US
Mailing Address - Phone:614-847-1100
Mailing Address - Fax:614-847-9200
Practice Address - Street 1:881 HIGH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4109
Practice Address - Country:US
Practice Address - Phone:614-847-1100
Practice Address - Fax:614-847-9200
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor