Provider Demographics
NPI:1639835804
Name:MARKS FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:MARKS FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC-LEAD
Authorized Official - Prefix:DR
Authorized Official - First Name:KOHL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-345-1669
Mailing Address - Street 1:1400 EXECUTIVE PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7109
Mailing Address - Country:US
Mailing Address - Phone:541-345-1669
Mailing Address - Fax:
Practice Address - Street 1:1400 EXECUTIVE PKWY STE 220
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7109
Practice Address - Country:US
Practice Address - Phone:541-345-1669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty