Provider Demographics
NPI:1689762726
Name:VARCKETTE, MARC (CH)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:VARCKETTE
Suffix:
Gender:M
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 HIGH STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4141
Mailing Address - Country:US
Mailing Address - Phone:614-888-2225
Mailing Address - Fax:614-847-1348
Practice Address - Street 1:5701 N HIGH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3960
Practice Address - Country:US
Practice Address - Phone:614-847-9526
Practice Address - Fax:614-847-1348
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4035621Medicare PIN
OHU82343Medicare UPIN