MEDICARE: DR. MARC STEVEN PERSSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC009312	PA
2	111N00000X	Chiropractor	AJ009132	PA

General Provider Information

NPI Number	:	1033104229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC STEVEN PERSSON D.C.

Provider Business Mailing Address
First Line	:	701 E MACDADE BLVD
Second Line	:
City	:	FOLSOM
State	:	PA
Zip	:	19033-2300
Country	:	US
Telephone Number	:	610-532-3401
Fax Number	:	610-532-3403

Provider Business Practice Location Address
First Line	:	701 E MACDADE BLVD
Second Line	:
City	:	FOLSOM
State	:	PA
Zip	:	19033-2300
Country	:	US
Telephone Number	:	610-532-3401
Fax Number	:	610-532-3403

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	06/14/2009

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