Provider Demographics
NPI:1689612947
Name:MARINO CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:MARINO CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-421-3060
Mailing Address - Street 1:507 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15207-1051
Mailing Address - Country:US
Mailing Address - Phone:412-421-3060
Mailing Address - Fax:412-421-0783
Practice Address - Street 1:507 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15207-1051
Practice Address - Country:US
Practice Address - Phone:412-421-3060
Practice Address - Fax:412-421-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007414L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty