MEDICARE: DR. MARCEL POPA DC

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	2013000342	MO

General Provider Information

NPI Number	:	1033457007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCEL POPA DC

Provider Business Mailing Address
First Line	:	17130 LAWRENCE 2109
Second Line	:
City	:	MOUNT VERNON
State	:	MO
Zip	:	65712-7447
Country	:	US
Telephone Number	:	417-894-1181
Fax Number	:	417-720-1251

Provider Business Practice Location Address
First Line	:	2725 N KANSAS EXPY
Second Line	:	STE 104
City	:	SPRINGFIELD
State	:	MO
Zip	:	65803-1113
Country	:	US
Telephone Number	:	417-720-1250
Fax Number	:	417-720-1251

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

Provider Enumeration Date	:	01/24/2013
Last Update Date	:	12/05/2016

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