Provider Demographics
NPI:1578623757
Name:LEVY, MARC ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ALLEN
Last Name:LEVY
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 1:167S TRADE ST F
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5771
Mailing Address - Country:US
Mailing Address - Phone:704-684-6090
Mailing Address - Fax:704-684-6091
Practice Address - Street 1:167S TRADE ST F
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5771
Practice Address - Country:US
Practice Address - Phone:704-684-6090
Practice Address - Fax:704-684-6091
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9187111N00000X
NC3688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor