Provider Demographics
NPI:1396115994
Name:MAMARZLUFF FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:MAMARZLUFF FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSIDIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MARZLUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-606-3980
Mailing Address - Street 1:6800 HERITAGE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8746
Mailing Address - Country:US
Mailing Address - Phone:972-463-9100
Mailing Address - Fax:866-226-4193
Practice Address - Street 1:6800 HERITAGE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-8746
Practice Address - Country:US
Practice Address - Phone:972-463-9100
Practice Address - Fax:866-226-4193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty