Provider Demographics
NPI:1669778627
Name:MARSH CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:MARSH CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-775-4000
Mailing Address - Street 1:101 H ST
Mailing Address - Street 2:STE D
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-5152
Mailing Address - Country:US
Mailing Address - Phone:707-775-4000
Mailing Address - Fax:
Practice Address - Street 1:101 H ST
Practice Address - Street 2:STE D
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-5152
Practice Address - Country:US
Practice Address - Phone:707-775-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty