Provider Demographics
NPI:1447385463
Name:DR. ANDREA MARCONI, LLC
Entity Type:Organization
Organization Name:DR. ANDREA MARCONI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCONI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-300-2014
Mailing Address - Street 1:37185 FRANKLINS FORD PL
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-4082
Mailing Address - Country:US
Mailing Address - Phone:703-300-2014
Mailing Address - Fax:
Practice Address - Street 1:37185 FRANKLINS FORD PL
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-4082
Practice Address - Country:US
Practice Address - Phone:703-300-2014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty