NPI 1508802695 · live from the CMS NPI Registry
Henry Charles Marquardt, D.C.
Chiropractor in Jackson, WY. National Provider Identifier 1508802695, active.
NPI record
| NPI | 1508802695 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 25 S Gros Ventre, Jackson, WY 83001 |
| Practice phone | 913-530-2889 |
| Mailing address | Po Box 4975, Jackson, WY 83001 |
| Enumerated | June 20, 2006 |
| Last updated | March 11, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor | 111N00000X | 01-04793 (KS) |
| Chiropractor primary | 111N00000X | 748 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.