Provider Demographics
NPI:1205932365
Name:MARQUIS, DAVID M (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:MARQUIS
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 1:260 STATION WAY STE A
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3359
Mailing Address - Country:US
Mailing Address - Phone:085-581-3442
Mailing Address - Fax:805-581-3443
Practice Address - Street 1:260 STATION WAY
Practice Address - Street 2:SUITE A
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3359
Practice Address - Country:US
Practice Address - Phone:805-581-3442
Practice Address - Fax:805-581-3443
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 24827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U68976Medicare UPIN