Provider Demographics
NPI:1467638213
Name:JUSTINE M. MARCUS DC LLC
Entity Type:Organization
Organization Name:JUSTINE M. MARCUS DC LLC
Other - Org Name:LAUREL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-446-5555
Mailing Address - Street 1:11695 ROUTE 56 HWY E
Mailing Address - Street 2:PO BOX 166
Mailing Address - City:ARMAGH
Mailing Address - State:PA
Mailing Address - Zip Code:15920-9025
Mailing Address - Country:US
Mailing Address - Phone:814-446-5555
Mailing Address - Fax:814-446-4147
Practice Address - Street 1:11695 ROUTE 56 HWY E
Practice Address - Street 2:
Practice Address - City:ARMAGH
Practice Address - State:PA
Practice Address - Zip Code:15920-9025
Practice Address - Country:US
Practice Address - Phone:814-446-5555
Practice Address - Fax:814-446-4147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty