Healthcare Provider Details

I. General information

NPI: 1093797409
Provider Name (Legal Business Name): JOSEPH B MARINACCI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2005
Last Update Date: 04/02/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 STATION PLACE
HURRICANE WV
25526-9480
US

IV. Provider business mailing address

3 STATION PLACE
HURRICANE WV
25526-6579
US

V. Phone/Fax

Practice location:
  • Phone: 304-757-7266
  • Fax: 304-757-9865
Mailing address:
  • Phone: 304-757-7266
  • Fax: 304-757-9865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number822
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: