MEDICARE: DR. JOHN MARK LANEY 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	CR 720	ME

General Provider Information

NPI Number	:	1326042755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MARK LANEY D.C.

Provider Business Mailing Address
First Line	:	213 CAPITOL ST
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-6232
Country	:	US
Telephone Number	:	207-623-4222
Fax Number	:	207-623-2343

Provider Business Practice Location Address
First Line	:	213 CAPITOL ST
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-6232
Country	:	US
Telephone Number	:	207-623-4222
Fax Number	:	207-623-2343

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	07/08/2007

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