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Individual

DR. MARC SCOTT DEGENNARO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
90 WHITEWOOD RD, SUITE #2, CHARLOTTESVILLE, VA 22901-1668
(434) 978-4473
(434) 978-4644
Mailing address
90 WHITEWOOD RD, SUITE #2, CHARLOTTESVILLE, VA 22901-1668
(434) 978-4473
(434) 978-4644

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1147
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000076114
ANTHEM PROVIDER NUMBER
VA
Enumeration date
09/21/2006
Last updated
07/22/2010
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