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General NPI Number Information
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NPI Number | 1184751869
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Entity Type | Individual
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Provider Name | MATTHEW JOHN MARR D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 201 GREAT OAKS TRL
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City | WADSWORTH
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State | OH
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Zip | 44281-9430
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Country | US
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Telephone | 330-336-9500
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Fax | 330-336-3377
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Provider Business Mailing Address
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Address Line | 201 GREAT OAKS TRL
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City | WADSWORTH
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State | OH
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Zip | 44281-9430
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Country | US
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Telephone | 330-336-9500
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Fax | 330-336-3377
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4093
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC009764
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License Number State | PA
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