Provider Demographics
NPI:1952711764
Name:MARZ CHIROPRACTIC PC
Entity Type:Organization
Organization Name:MARZ CHIROPRACTIC PC
Other - Org Name:RIVERVIEW CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:MARZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-276-9311
Mailing Address - Street 1:3505 8TH ST S
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-5108
Mailing Address - Country:US
Mailing Address - Phone:218-236-1516
Mailing Address - Fax:218-331-0077
Practice Address - Street 1:3505 8TH ST S
Practice Address - Street 2:SUITE 6
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5108
Practice Address - Country:US
Practice Address - Phone:218-236-1516
Practice Address - Fax:218-331-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty