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General NPI Number Information
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NPI Number | 1528239290
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Entity Type | Organization
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Legal Business Name | MAROTTA HEALTH AND WELLNESS CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 939 ROUTE 146 #230
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3662
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Country | US
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Telephone | 518-357-3347
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Fax |
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Provider Business Mailing Address
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Address Line | 939 ROUTE 146 #230
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3662
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Country | US
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Telephone | 518-357-3347
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTONIO VR MAROTTA
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Credential | D.C.
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Telephone | 518-357-3347
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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 | X011500
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License Number State | NY
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