MEDICARE: MARCY SEDONA SERVICES, INC

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

General Provider Information

NPI Number	:	1215994793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCY SEDONA SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 2580
Second Line	:
City	:	CAMP VERDE
State	:	AZ
Zip	:	86322-2580
Country	:	US
Telephone Number	:	928-567-4846
Fax Number	:	928-567-9606

Provider Business Practice Location Address
First Line	:	348 S MAIN ST
Second Line	:
City	:	CAMP VERDE
State	:	AZ
Zip	:	86322-7155
Country	:	US
Telephone Number	:	928-567-4846
Fax Number	:	928-567-9606

Authorized Official
Title or Position	:	OFFICER/DIRECTOR
Name	:	DR. HOMER KENNETH MARCY
Credential	:	D.C.
Telephone Number	:	928-567-4846

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	08/22/2020

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