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NPI Code Detail

MEDICARE: DR. MARK ALTON PIERCE SR. D.C

MEDICARE: DR. MARK ALTON PIERCE SR. 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
1111N00000XChiropractorCH6451FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CH6451OTHERFLCHIROPRACTIC PHYSICIAN #

General Provider Information

NPI Number : 1962448209
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK ALTON PIERCE SR. D.C
Provider Business Mailing Address
First Line : 12620 BEACH BLVD
Second Line : SUITE 6
City : JACKSONVILLE
State : FL
Zip : 32246-7131
Country : US
Telephone Number : 904-645-0777
Fax Number : 904-645-3483
Provider Business Practice Location Address
First Line : 12620 BEACH BLVD
Second Line : SUITE 6
City : JACKSONVILLE
State : FL
Zip : 32246-7131
Country : US
Telephone Number : 904-645-0777
Fax Number : 904-645-3483
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/30/2015

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