Provider Demographics
NPI:1881191757
Name:RESTORE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:RESTORE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MARQUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-962-4693
Mailing Address - Street 1:175 E CAMPUS VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-6604
Mailing Address - Country:US
Mailing Address - Phone:614-505-0900
Mailing Address - Fax:
Practice Address - Street 1:175 E CAMPUS VIEW BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-6604
Practice Address - Country:US
Practice Address - Phone:614-505-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-09
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty