MEDICARE: MARISSA STURGES DC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1083368666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARISSA STURGES DC PC

Provider Business Mailing Address
First Line	:	PO BOX 549
Second Line	:
City	:	CHANHASSEN
State	:	MN
Zip	:	55317-0549
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25600 RANCHO NIGUEL RD
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-7303
Country	:	US
Telephone Number	:	952-229-7464
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	REZA ALIZADEH
Credential	:
Telephone Number	:	952-229-7464

Provider Enumeration Date	:	02/11/2022
Last Update Date	:	02/11/2022

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Directions to “MARISSA STURGES DC PC ” Practice Location

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