Provider Demographics
NPI:1760457030
Name:MARICK, ANGELA LINDENMUTH (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LINDENMUTH
Last Name:MARICK
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 1:2021 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2842
Mailing Address - Country:US
Mailing Address - Phone:717-751-0004
Mailing Address - Fax:717-751-0079
Practice Address - Street 1:2021 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2842
Practice Address - Country:US
Practice Address - Phone:717-751-0004
Practice Address - Fax:717-751-0079
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-009061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU96458Medicare UPIN
PA072375H21Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER