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General NPI Number Information
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NPI Number | 1699043851
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Entity Type | Organization
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Legal Business Name | MARCUS CHIROPRACTIC CENTER, INC
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 2710 E OAKLAND PARK BLVD
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1605
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Country | US
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Telephone | 954-575-1175
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Fax | 954-566-0361
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Provider Business Mailing Address
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Address Line | 2710 E. OAKLAND PARK BLVD.
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City | FT. LAUDERDALE
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State | FL
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Zip | 33306
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Country | US
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Telephone | 954-575-1175
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Fax | 954-566-0361
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. PETER J. MARCUS
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Credential | DC
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Telephone | 954-575-1175
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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 | CH7508
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License Number State | FL
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