Provider Demographics
NPI:1790835916
Name:MACKENZIE, MARJORIE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:
Last Name:MACKENZIE
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 1:200 BANNING ST
Mailing Address - Street 2:STE 350
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3485
Mailing Address - Country:US
Mailing Address - Phone:302-730-8848
Mailing Address - Fax:302-730-8846
Practice Address - Street 1:200 BANNING ST
Practice Address - Street 2:SUITE 350
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3485
Practice Address - Country:US
Practice Address - Phone:302-730-8848
Practice Address - Fax:302-730-8846
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000601111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE113058OtherCOVENTRY
DE298136OtherMAMSI
DE386606CHIOtherBLUE CROSS & BLUE SHIELD
DE2257287000OtherAMERIHEALTH HMO
DE648927OtherUNITED HEALTH CARE
DE1577494OtherAMERIHEALTH PPO
DE3988000OtherCIGNA
DE2257287000OtherAMERIHEALTH HMO
DEU62690Medicare UPIN