Healthcare Provider Details

I. General information

NPI: 1598076523
Provider Name (Legal Business Name): MARCELLE PARRY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1452 VALENCIA ST
SAN FRANCISCO CA
94110-3717
US

IV. Provider business mailing address

148 CRESCENT RD
CORTE MADERA CA
94925-1316
US

V. Phone/Fax

Practice location:
  • Phone: 415-793-7247
  • Fax:
Mailing address:
  • Phone: 415-793-7247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number22099
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number22099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: