Provider Demographics
NPI:1467152959
Name:GEVERS, MARSHALL (DC)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:
Last Name:GEVERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-6355
Mailing Address - Country:US
Mailing Address - Phone:618-520-8270
Mailing Address - Fax:
Practice Address - Street 1:4225 S STATE ROUTE 159 STE 2
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-3231
Practice Address - Country:US
Practice Address - Phone:618-520-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor