=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063167203
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARKUS HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2022
-----------------------------------------------------
Last Update Date | 02/22/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1700 E ELLIOT RD STE 12
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85284-1650
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-611-7752
-----------------------------------------------------
Fax | 602-661-7756
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1700 E ELLIOT RD STE 12
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85284-1650
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-661-7752
-----------------------------------------------------
Fax | 602-661-7756
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/CHIROPRACTOR
-----------------------------------------------------
Name | DR. DANIEL MARKUS
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 602-661-7752
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------