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Individual

DR. MARK CRESTON MARIEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
19315 W CATAWBA AVE, SUITE 100, CORNELIUS, NC 28031-8650
(704) 896-1811
(239) 542-8193
Mailing address
19315 WEST CATAWBA AVENUE, SUITE 100, CORNELIUS, NC 28031
(704) 896-1811
(239) 542-8193

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH9058
FL
111NS0005X
Sports Physician Chiropractor
4334
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
70040
BLUE CROSS
FL
Enumeration date
07/18/2005
Last updated
08/20/2013
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