Provider Demographics
NPI:1285792929
Name:CASTANEDA, MARCO E (DC)
Entity type:Individual
Prefix:DR
First Name:MARCO
Middle Name:E
Last Name:CASTANEDA
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 1:7786 EMORY CHASE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-6147
Mailing Address - Country:US
Mailing Address - Phone:865-454-0313
Mailing Address - Fax:
Practice Address - Street 1:7786 EMORY CHASE LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-6147
Practice Address - Country:US
Practice Address - Phone:865-454-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2115111NS0005X, 111NT0100X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NT0100XChiropractic ProvidersChiropractorThermography