Provider Demographics
NPI:1891760369
Name:MARRA-PATTS, DANIELLE (DC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MARRA-PATTS
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 1:4950 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-9240
Mailing Address - Country:US
Mailing Address - Phone:724-387-1014
Mailing Address - Fax:
Practice Address - Street 1:4950 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:EXPORT
Practice Address - State:PA
Practice Address - Zip Code:15632-9240
Practice Address - Country:US
Practice Address - Phone:724-387-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007807L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA528168OtherHIGHMARK
PA528168OtherHIGHMARK
PA045774QNFMedicare ID - Type Unspecified