Provider Demographics
NPI:1821205337
Name:FERRIN, MARC A (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:FERRIN
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 1:2707 W. EDGEWOOD DR.
Mailing Address - Street 2:STE. 104
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109
Mailing Address - Country:US
Mailing Address - Phone:573-893-9800
Mailing Address - Fax:888-335-8965
Practice Address - Street 1:2707 W EDGEWOOD DR STE 104
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5886
Practice Address - Country:US
Practice Address - Phone:573-893-9800
Practice Address - Fax:888-335-8965
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033961111N00000X
MO2009001038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0157660OtherL&I
WAU84244Medicare UPIN
WA0157660OtherL&I