Provider Demographics
NPI:1841226313
Name:BUNKER, MARISSA HOLMES (DC)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:HOLMES
Last Name:BUNKER
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 1:1620 TWEED ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1423
Mailing Address - Country:US
Mailing Address - Phone:301-455-7832
Mailing Address - Fax:
Practice Address - Street 1:1620 TWEED ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20851-1423
Practice Address - Country:US
Practice Address - Phone:301-455-7832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03557111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor