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NPI Code Detail

MEDICARE: DR. MARCUS TYSON COOL D.C.

MEDICARE: DR. MARCUS TYSON COOL D.C.
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
1111N00000XChiropractor3796OR

General Provider Information

NPI Number : 1841476132
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCUS TYSON COOL D.C.
Provider Business Mailing Address
First Line : 220 5TH AVE SW
Second Line :
City : ALBANY
State : OR
Zip : 97321-2345
Country : US
Telephone Number : 541-926-0510
Fax Number : 541-926-5540
Provider Business Practice Location Address
First Line : 220 5TH AVE SW
Second Line :
City : ALBANY
State : OR
Zip : 97321-2345
Country : US
Telephone Number : 541-926-0510
Fax Number : 541-926-5540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2008
Last Update Date : 08/11/2011

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Directions to “ DR. MARCUS TYSON COOL D.C.” Practice Location

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