Individual
ANN LAUREN MARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C., C.I.M.E.
Contact information
Practice address
12082 CORTEZ BLVD, BROOKSVILLE, FL 34613-7371
(352) 684-2707
(352) 688-1282
Mailing address
12082 CORTEZ BLVD, BROOKSVILLE, FL 34613-7371
(352) 684-2707
(352) 688-1282
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1509
AL
111N00000X
Chiropractor
Primary
H6649
FL
111N00000X
Chiropractor
INACTIVE STATUS
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K8155
MEDICARE PTAN
FL
Enumeration date
08/23/2005
Last updated
09/15/2015
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