Provider Demographics
NPI:1356925242
Name:MCKENNA, MARCIE S (DC)
Entity type:Individual
Prefix:DR
First Name:MARCIE
Middle Name:S
Last Name:MCKENNA
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 1:3145 170TH ST
Mailing Address - Street 2:
Mailing Address - City:DYSART
Mailing Address - State:IA
Mailing Address - Zip Code:52224-9550
Mailing Address - Country:US
Mailing Address - Phone:319-429-0529
Mailing Address - Fax:
Practice Address - Street 1:204 W SEERLEY BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-4207
Practice Address - Country:US
Practice Address - Phone:319-260-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor