Provider Demographics
NPI:1891055786
Name:MARINARO CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:MARINARO CHIROPRACTIC INC.
Other - Org Name:PAIN RELIEF CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.F.O. / ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKISSIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-653-3344
Mailing Address - Street 1:8300 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4311
Mailing Address - Country:US
Mailing Address - Phone:323-653-3344
Mailing Address - Fax:323-653-5853
Practice Address - Street 1:8300 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4311
Practice Address - Country:US
Practice Address - Phone:323-653-3344
Practice Address - Fax:323-653-5853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty