Provider Demographics
NPI:1629366851
Name:MARLIN CHIROPRACTIC CENTER PLLC
Entity Type:Organization
Organization Name:MARLIN CHIROPRACTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-753-1447
Mailing Address - Street 1:854 VALLEY RD
Mailing Address - Street 2:STE 200
Mailing Address - City:MOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27028-2942
Mailing Address - Country:US
Mailing Address - Phone:336-753-1447
Mailing Address - Fax:336-753-1463
Practice Address - Street 1:854 VALLEY RD
Practice Address - Street 2:STE 200
Practice Address - City:MOCKSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27028-2942
Practice Address - Country:US
Practice Address - Phone:336-753-1447
Practice Address - Fax:336-753-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty