Provider Demographics
NPI:1376692798
Name:MARILYN SANTELLI DC PC INC
Entity Type:Organization
Organization Name:MARILYN SANTELLI DC PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-603-4844
Mailing Address - Street 1:6924 NW 112TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2976
Mailing Address - Country:US
Mailing Address - Phone:405-603-4844
Mailing Address - Fax:
Practice Address - Street 1:6924 NW 112TH ST STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-2976
Practice Address - Country:US
Practice Address - Phone:405-603-4844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2270111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKV09143Medicare UPIN