Provider Demographics
NPI:1306805270
Name:TINDLE, MARLYN JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:MARLYN
Middle Name:JAMES
Last Name:TINDLE
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 1:2224 W SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-2713
Mailing Address - Country:US
Mailing Address - Phone:515-462-2317
Mailing Address - Fax:
Practice Address - Street 1:2224 W SUMMIT ST
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-2713
Practice Address - Country:US
Practice Address - Phone:515-462-2317
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0144733Medicaid
IA0144733Medicaid