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General NPI Number Information
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NPI Number | 1154535011
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Entity Type | Organization
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Legal Business Name | MARMO SPINE & REHAB, LTD
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 N WHITE ST
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City | FRANKFORT
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State | IL
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Zip | 60423-1456
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Country | US
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Telephone | 815-469-9270
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Fax | 815-469-9544
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Provider Business Mailing Address
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Address Line | 301 N. WHITE ST
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City | FRANKFORT
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State | IL
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Zip | 60423
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Country | US
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Telephone | 815-469-9270
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Fax | 815-469-9544
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEREMY J MARMO
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Credential | D.C.
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Telephone | 815-469-9270
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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 |
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License Number State | IL
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