Provider Demographics
NPI:1780030171
Name:A. MARSE MANAGEMENT, PLLC
Entity Type:Organization
Organization Name:A. MARSE MANAGEMENT, PLLC
Other - Org Name:PEAK CHIROPRACTIC AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-482-6187
Mailing Address - Street 1:2901 ACME BRICK PLZ # 201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4124
Mailing Address - Country:US
Mailing Address - Phone:817-482-6187
Mailing Address - Fax:817-887-1222
Practice Address - Street 1:2901 ACME BRICK PLZ # 201
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4124
Practice Address - Country:US
Practice Address - Phone:817-482-6187
Practice Address - Fax:817-887-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty