Provider Demographics
NPI:1821133968
Name:MARCHIORI, RICHARD P (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:MARCHIORI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 PARK PL NE
Mailing Address - Street 2:SUITE G4
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-2001
Mailing Address - Country:US
Mailing Address - Phone:319-294-2170
Mailing Address - Fax:
Practice Address - Street 1:1221 PARK PLACE NE
Practice Address - Street 2:SUITE G4
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-2001
Practice Address - Country:US
Practice Address - Phone:319-294-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA47228OtherWELLMARK BLUE CROSS
IAI12005Medicare ID - Type Unspecified
IA47228OtherWELLMARK BLUE CROSS