MEDICARE: MICHAEL DIMARCO II 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	9145	AZ
2	111N00000X	Chiropractor	38MC00709900	NJ

General Provider Information

NPI Number	:	1134545833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DIMARCO II D.C.

Provider Business Mailing Address
First Line	:	45 CASTLE ROCK RD STE 3
Second Line	:
City	:	SEDONA
State	:	AZ
Zip	:	86351-8806
Country	:	US
Telephone Number	:	928-254-7099
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 CASTLE ROCK RD STE 3
Second Line	:
City	:	SEDONA
State	:	AZ
Zip	:	86351-8806
Country	:	US
Telephone Number	:	928-254-7099
Fax Number	:

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

Provider Enumeration Date	:	03/05/2014
Last Update Date	:	04/12/2022

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