Healthcare Provider Details
I. General information
NPI: 1285525543
Provider Name (Legal Business Name): MARK B LETTERMAN DC, OMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 REHOBOTH AVE
REHOBOTH BEACH DE
19971-2171
US
IV. Provider business mailing address
1803 SLAUGHTER STATION RD
HARTLY DE
19953-3222
US
V. Phone/Fax
- Phone: 302-612-1077
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | CT-0010019 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | F1-0011109 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: