Healthcare Provider Details

I. General information

NPI: 1972642692
Provider Name (Legal Business Name): MARJORIE STE MARIE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 HILL STREET
DANVILLE VT
05828
US

IV. Provider business mailing address

PO BOX 298
DANVILLE VT
05828
US

V. Phone/Fax

Practice location:
  • Phone: 802-684-9707
  • Fax: 802-684-9707
Mailing address:
  • Phone: 802-684-9707
  • Fax: 802-684-9707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006-0001126
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: