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General NPI Number Information
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NPI Number | 1316128135
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Entity Type | Organization
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Legal Business Name | MARK M. POMERANTZ, D.C., P.C.
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 111 CHERRY ST
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City | MILFORD
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State | CT
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Zip | 06460-3414
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Country | US
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Telephone | 203-874-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 111 CHERRY ST
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City | MILFORD
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State | CT
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Zip | 06460-3414
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Country | US
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Telephone | 203-874-2224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK MICHAEL POMERANTZ
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Credential | D.C.
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Telephone | 203-874-2224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 814
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License Number State | CT
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