Healthcare Provider Details

I. General information

NPI: 1386835536
Provider Name (Legal Business Name): MAREK CHIROPRACTIC INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 UNITED WAY
FREDERIC WI
54837-9052
US

IV. Provider business mailing address

101 UNITED WAY
FREDERIC WI
54837-9052
US

V. Phone/Fax

Practice location:
  • Phone: 715-327-4253
  • Fax: 715-327-4270
Mailing address:
  • Phone: 715-327-4253
  • Fax: 715-327-4270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3097-012
License Number StateWI

VIII. Authorized Official

Name: DR. JOSEPH L. MAREK
Title or Position: PRESIDENT
Credential: D.C.
Phone: 715-327-4253