Provider Demographics
NPI:1699093633
Name:MARSTON, JOSHUA (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:MARSTON
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 1:3298 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-6758
Mailing Address - Country:US
Mailing Address - Phone:208-522-3863
Mailing Address - Fax:385-881-1122
Practice Address - Street 1:3298 E 17TH ST
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-6758
Practice Address - Country:US
Practice Address - Phone:208-522-3863
Practice Address - Fax:385-881-1122
Is Sole Proprietor?:No
Enumeration Date:2010-05-15
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-2114111N00000X
MTCHI-CHI-LIC-1841111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor