MEDICARE: MARKLAND CHIROPRACTIC CLINIC, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH7272	FL

General Provider Information

NPI Number	:	1316254063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARKLAND CHIROPRACTIC CLINIC, INC.

Provider Business Mailing Address
First Line	:	116 N COUNTY ROAD 470
Second Line	:
City	:	LAKE PANASOFFKEE
State	:	FL
Zip	:	33538-6048
Country	:	US
Telephone Number	:	352-793-3337
Fax Number	:	352-793-3337

Provider Business Practice Location Address
First Line	:	116 N COUNTY ROAD 470
Second Line	:
City	:	LAKE PANASOFFKEE
State	:	FL
Zip	:	33538-6048
Country	:	US
Telephone Number	:	352-793-3337
Fax Number	:	352-793-3337

Authorized Official
Title or Position	:	OWNER
Name	:	KARRIE L MARKLAND
Credential	:	DC
Telephone Number	:	352-793-3337

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	09/02/2010

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