Provider Demographics
NPI:1720003221
Name:EVERETT, MARILYN (DC)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:EVERETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2323
Mailing Address - Country:US
Mailing Address - Phone:931-685-0040
Mailing Address - Fax:931-685-0045
Practice Address - Street 1:1509 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2323
Practice Address - Country:US
Practice Address - Phone:931-685-0040
Practice Address - Fax:931-685-0045
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0056239OtherBCBS
TN1035936OtherAETNA
TN623079OtherUNITED HEALTH CARE
TN623079OtherUNITED HEALTH CARE
TN0056239OtherBCBS
TNT74622Medicare UPIN