# MARVEL CHIROPRACTIC AND WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699924373
- **Authorized official:** DR. MICHELLE D. MARVEL D.C. (MANAGER)
- **Authorized official phone:** (618) 983-8100

## Contact information

- **Practice address:** 417 E BROADWAY BLVD, JOHNSTON CITY, IL 62951-1608
- **Practice address phone:** (618) 983-8100
- **Practice address fax:** (618) 983-8110
- **Mailing address:** 417 E BROADWAY BLVD, JOHNSTON CITY, IL 62951-1608
- **Mailing address phone:** (618) 983-8100
- **Mailing address fax:** (618) 983-8110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 038.011177 | IL | Yes |

## Other

- **Enumeration date:** 09/17/2008
- **Last updated:** 01/06/2009