Provider Demographics
NPI:1427163716
Name:MARION FAMILY CHIROPRACTIC INC
Entity type:Organization
Organization Name:MARION FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ATCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-748-6633
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-0003
Mailing Address - Country:US
Mailing Address - Phone:508-748-6633
Mailing Address - Fax:508-748-6649
Practice Address - Street 1:238 WAREHAM RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1166
Practice Address - Country:US
Practice Address - Phone:508-748-6633
Practice Address - Fax:508-748-6649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9796657Medicaid
Y40133OtherBCBS GROUP NUMBER
MA9796657Medicaid