Provider Demographics
NPI:1497188023
Name:RICKS, MARSHELENE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARSHELENE
Middle Name:
Last Name:RICKS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 SW 3RD CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4603
Mailing Address - Country:US
Mailing Address - Phone:407-399-3606
Mailing Address - Fax:
Practice Address - Street 1:229 SW 3RD CT
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4603
Practice Address - Country:US
Practice Address - Phone:407-399-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor