Provider Demographics
NPI:1710019070
Name:GUARINO CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:GUARINO CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0WNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:G
Authorized Official - Last Name:GUARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-747-7474
Mailing Address - Street 1:10148 WEST BROAD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060
Mailing Address - Country:US
Mailing Address - Phone:804-747-7474
Mailing Address - Fax:804-965-9360
Practice Address - Street 1:10148 W BROAD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6760
Practice Address - Country:US
Practice Address - Phone:804-747-7474
Practice Address - Fax:804-965-9360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1396726188OtherNPI DR MARK GUARINO
VA4400136OtherUNITED HEALTH CARE
VA170425OtherSOUTHERN HEALTH
VA1456026OtherBLUE CRROSS HIGH MARK
VA0827590OtherCIGNA
VA1922063890OtherDR LISA ANNE HOLLAND NPI