Individual
DR. HENRY CHARLES MARQUARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
25 S GROS VENTRE, JACKSON, WY 83001
(913) 530-2889
(307) 200-6639
Mailing address
PO BOX 4975, JACKSON, WY 83001-4975
(913) 530-2889
(307) 200-6639
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
01-04793
KS
111N00000X
Chiropractor
Primary
748
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007492452
AETNA PIN
KS
01
—
32234012
BLUECROSS BLUESHIELD PIN
KS
Enumeration date
06/20/2006
Last updated
03/11/2015
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