Provider Demographics
NPI:1588693295
Name:MARCOUX CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:MARCOUX CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARCOUX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-552-8531
Mailing Address - Street 1:2693 OAK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-9485
Mailing Address - Country:US
Mailing Address - Phone:517-552-8531
Mailing Address - Fax:
Practice Address - Street 1:2693 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-9485
Practice Address - Country:US
Practice Address - Phone:517-552-8531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004528111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950Q250470OtherBLUE CROSS
MIJM004528OtherWORK COMP 2
MIJM004528OtherCOMMERCIAL
MIJM004528OtherWORK COMP 1
MI0Q25047Medicare ID - Type UnspecifiedMEDICARE
MI950Q250470OtherBLUE CROSS