Provider Demographics
NPI:1831203033
Name:CONSTANTINIDES, MARION H (DC)
Entity type:Individual
Prefix:DR
First Name:MARION
Middle Name:H
Last Name:CONSTANTINIDES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MARION
Other - Middle Name:H
Other - Last Name:ODELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4532 BONNEY RD D
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3870
Mailing Address - Country:US
Mailing Address - Phone:757-965-2476
Mailing Address - Fax:877-478-9429
Practice Address - Street 1:4532 BONNEY RD D
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3870
Practice Address - Country:US
Practice Address - Phone:757-965-2476
Practice Address - Fax:877-478-9429
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR713674111N00000X
VA0104556540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor