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General NPI Number Information
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NPI Number | 1376611582
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Entity Type | Individual
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Provider Name | JOEL EDWIN MARLEY D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 11/09/2008
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Provider Practice Location Address
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Address Line | 18025 OAK DRIVE SUITE A
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City | OMAHA
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State | NE
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Zip | 68130
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Country | US
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Telephone | 712-420-1358
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Fax |
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Provider Business Mailing Address
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Address Line | 18025 OAK ST SUITE A
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City | OMAHA
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State | NE
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Zip | 68130-6093
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Country | US
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Telephone | 402-884-4100
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Fax |
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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 | 768-08-06
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License Number State | NH
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