Provider Demographics
NPI:1003332305
Name:MARATHON CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:MARATHON CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-264-6474
Mailing Address - Street 1:920 W KING ST STE B
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3467
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:920 W KING ST STE B
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-3467
Practice Address - Country:US
Practice Address - Phone:828-264-6474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty