Provider Demographics
NPI:1972642692
Name:STE MARIE, MARJORIE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:
Last Name:STE MARIE
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:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05828
Mailing Address - Country:US
Mailing Address - Phone:802-684-9707
Mailing Address - Fax:802-684-9707
Practice Address - Street 1:32 HILL STREET
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VT
Practice Address - Zip Code:05828
Practice Address - Country:US
Practice Address - Phone:802-684-9707
Practice Address - Fax:802-684-9707
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0001126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
245711045OtherCBA
3731847OtherAFNA
054008992VT01OtherBC BS OF NH
STE59462OtherBC BS
054008992VT01OtherBC BS OF NH
245711045OtherCBA