Healthcare Provider Details

I. General information

NPI: 1992162036
Provider Name (Legal Business Name): MARCEL GARCIA CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 NW MARTIN LUTHER KING JR BLVD
EVANSVILLE IN
47708-1903
US

IV. Provider business mailing address

319 NW MARTIN LUTHER KING JR BLVD
EVANSVILLE IN
47708-1903
US

V. Phone/Fax

Practice location:
  • Phone: 812-423-9146
  • Fax: 775-766-6516
Mailing address:
  • Phone: 812-423-9146
  • Fax: 775-766-6516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number08002877A
License Number StateIN

VIII. Authorized Official

Name: DR. MARCEL M GARCIA-HOSOKAWA
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 812-306-4671