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General NPI Number Information
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NPI Number | 1346937026
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Entity Type | Organization
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Legal Business Name | MADE 4 MOVEMENT PLLC
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 1979 MCCULLOCH BLVD N STE 101
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-0963
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Country | US
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Telephone | 928-466-6390
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Fax |
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Provider Business Mailing Address
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Address Line | 1979 MCCULLOCH BLVD N STE 101
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-0963
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Country | US
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Telephone | 928-466-6390
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. MADISON MARQUEZ
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Credential | DC
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Telephone | 928-466-6390
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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 |
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