Provider Demographics
NPI:1427523570
Name:HARRELL, MARITA L (DC)
Entity type:Individual
Prefix:MRS
First Name:MARITA
Middle Name:L
Last Name:HARRELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:MARITA
Other - Middle Name:
Other - Last Name:MCCLELLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:335 HWY 199E
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082
Mailing Address - Country:US
Mailing Address - Phone:817-220-9100
Mailing Address - Fax:817-220-9109
Practice Address - Street 1:335 HWY 199E
Practice Address - Street 2:
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082
Practice Address - Country:US
Practice Address - Phone:817-220-9100
Practice Address - Fax:817-220-9109
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor