Provider Demographics
NPI:1952341521
Name:SANTELLI, MARILYN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:SANTELLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5727
Mailing Address - Country:US
Mailing Address - Phone:405-603-4844
Mailing Address - Fax:405-603-7081
Practice Address - Street 1:6924 NW112TH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142
Practice Address - Country:US
Practice Address - Phone:405-603-4844
Practice Address - Fax:405-603-7081
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2270111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK243708801Medicare ID - Type Unspecified
OKV09143Medicare UPIN