Provider Demographics
NPI:1427152545
Name:KESTEN, MARCIA S (DC)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:S
Last Name:KESTEN
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:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:E SMITHFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18817-0066
Mailing Address - Country:US
Mailing Address - Phone:570-596-7600
Mailing Address - Fax:
Practice Address - Street 1:MAIN STREET
Practice Address - Street 2:
Practice Address - City:E SMITHFIELD
Practice Address - State:PA
Practice Address - Zip Code:18817-0066
Practice Address - Country:US
Practice Address - Phone:570-596-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 3142L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA155583Medicare ID - Type UnspecifiedPROVIDER BILING NUMBER