Healthcare Provider Details

I. General information

NPI: 1053573105
Provider Name (Legal Business Name): MARRICH CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NMARRICH CHIROPRACTIC INC 3401 CARLISLE BLVD NE
ALBUQUERQUE NM
87110
US

IV. Provider business mailing address

3401 CARLISLE BLVD NE
ALBUQUERQUE NM
87110
US

V. Phone/Fax

Practice location:
  • Phone: 505-889-3333
  • Fax:
Mailing address:
  • Phone: 505-889-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number667
License Number StateNM

VIII. Authorized Official

Name: MS. JOSLYNN GERBER
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-889-3333