Provider Demographics
NPI:1265437115
Name:MARRICH, LAWRENCE E (DC07191951)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:E
Last Name:MARRICH
Suffix:
Gender:M
Credentials:DC07191951
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 CARLISLE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1648
Mailing Address - Country:US
Mailing Address - Phone:505-889-3333
Mailing Address - Fax:505-837-2677
Practice Address - Street 1:3401 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1648
Practice Address - Country:US
Practice Address - Phone:505-889-3333
Practice Address - Fax:505-837-2677
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor