Provider Demographics
NPI:1942300850
Name:MARQUISSEE, GREGORY JON (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JON
Last Name:MARQUISSEE
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 1:5425 E BELL RD
Mailing Address - Street 2:SUITE150
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6007
Mailing Address - Country:US
Mailing Address - Phone:602-404-7557
Mailing Address - Fax:602-493-2526
Practice Address - Street 1:7500 E DEER VALLEY RD
Practice Address - Street 2:150
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4814
Practice Address - Country:US
Practice Address - Phone:480-502-6985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor