Healthcare Provider Details

I. General information

NPI: 1689762726
Provider Name (Legal Business Name): MARC VARCKETTE CH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 N HIGH ST SUITE 110
WORTHINGTON OH
43085-3960
US

IV. Provider business mailing address

870 HIGH STREET SUITE 104
WORTHINGTON OH
43085-4141
US

V. Phone/Fax

Practice location:
  • Phone: 614-847-9526
  • Fax: 614-847-1348
Mailing address:
  • Phone: 614-888-2225
  • Fax: 614-847-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3044
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: