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NPI Code Detail

MEDICARE: ANDRE ALPHONSE MARSE DC

MEDICARE: ANDRE ALPHONSE MARSE DC
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
1111N00000XChiropractor1384LA
2111N00000XChiropractor11483TX

General Provider Information

NPI Number : 1154335552
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRE ALPHONSE MARSE DC
Provider Business Mailing Address
First Line : 2901 ACME BRICK PLZ # 201
Second Line : SUITE 100
City : FORT WORTH
State : TX
Zip : 76109-4124
Country : US
Telephone Number : 817-882-6754
Fax Number : 817-887-1222
Provider Business Practice Location Address
First Line : 2901 ACME BRICK PLZ
Second Line : SUITE 100
City : FORT WORTH
State : TX
Zip : 76109-4124
Country : US
Telephone Number : 817-882-6754
Fax Number : 817-887-1222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 04/18/2017

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Directions to “ ANDRE ALPHONSE MARSE DC” Practice Location

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