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General NPI Number Information
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NPI Number | 1114048634
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Entity Type | Organization
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Legal Business Name | MARZILLI CHIROPRACTIC CENTER, LTD.
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1395 ATWOOD AVE SUITE 108A
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City | JOHNSTON
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State | RI
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Zip | 02919-4929
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Country | US
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Telephone | 401-270-9595
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Fax | 401-383-5155
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Provider Business Mailing Address
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Address Line | 1395 ATWOOD AVE SUITE 108A
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City | JOHNSTON
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State | RI
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Zip | 02919-4929
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Country | US
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Telephone | 401-270-9595
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Fax | 401-383-5155
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT B MARZILLI JR.
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Credential | DC
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Telephone | 401-270-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DCP00391
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License Number State | RI
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