Healthcare Provider Details

I. General information

NPI: 1023489713
Provider Name (Legal Business Name): MARK THOMAS ZARANSKI PHD, DIPL.OM, B.S.,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2015
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 INDIANAPOLIS BLVD BLDG 1 SUITE A
HIGHLAND IN
46322-2664
US

IV. Provider business mailing address

9501 INDIANAPOLIS BLVD BLDG 1 SUITE A
HIGHLAND IN
46322-2664
US

V. Phone/Fax

Practice location:
  • Phone: 219-595-5529
  • Fax: 219-513-9273
Mailing address:
  • Phone: 219-595-5529
  • Fax: 219-513-9273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number84000138A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: