Individual
MARC DAQUILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
160 BENMONT AVE, SUITE 23, BENNINGTON, VT 05201-1873
(802) 447-3455
Mailing address
160 BENMONT AVE, SUITE 23, BENNINGTON, VT 05201-1873
(802) 447-3455
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1880
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00019467
BLUECROSS VT
VT
01
—
05-0411280
TAX ID
VT
01
—
MA-1880
LICENSE MASS
MA
01
—
Y36358
BLUECROSS MASS
MA
Enumeration date
08/21/2006
Last updated
04/30/2008
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