Provider Demographics
NPI:1477828408
Name:MARCHEGIANI, JUSTIN RAYMOND (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:RAYMOND
Last Name:MARCHEGIANI
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 1:2028 E BEN WHITE BLVD # 240-2655
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6966
Mailing Address - Country:US
Mailing Address - Phone:512-535-1817
Mailing Address - Fax:
Practice Address - Street 1:2028 E BEN WHITE BLVD # 240-2655
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-6966
Practice Address - Country:US
Practice Address - Phone:512-535-1817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12479111N00000X
CA32222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor