Provider Demographics
NPI:1801940143
Name:MARLETTE, TODD (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:MARLETTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 S MARION RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-1309
Mailing Address - Country:US
Mailing Address - Phone:605-361-2500
Mailing Address - Fax:605-362-1930
Practice Address - Street 1:3600 S MARION RD STE 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-1309
Practice Address - Country:US
Practice Address - Phone:605-361-2500
Practice Address - Fax:605-362-1930
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7601890Medicaid
SD7025244OtherAETNA
SD697035OtherACN GROUP
SD0007706OtherBLUE CROSS BLUE SHEILD
SD0007706OtherFIRST ADMINISTATORS
SDMIDLANDSOtherMIDLANDS
SD0007706OtherFIRST ADMINISTATORS