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General NPI Number Information
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NPI Number | 1518919851
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Entity Type | Individual
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Provider Name | ANTHONY DAVID MARRONE D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 801 NE 28TH AVE
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City | PORTLAND
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State | OR
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Zip | 97232-2408
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Country | US
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Telephone | 503-281-4997
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Fax |
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Provider Business Mailing Address
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Address Line | 801 NE 28TH AVE
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City | PORTLAND
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State | OR
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Zip | 97232-2408
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Country | US
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Telephone | 503-281-4997
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 3470
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License Number State | OR
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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 | 27 3470
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License Number State | OR
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