MEDICARE: RUSS MARC SEGER 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	CH5626	FL

General Provider Information

NPI Number	:	1699742155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSS MARC SEGER D.C.

Provider Business Mailing Address
First Line	:	4623 FOREST HILL BLVD
Second Line	:	SUITE 101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-7469
Country	:	US
Telephone Number	:	561-967-8888
Fax Number	:	561-641-8303

Provider Business Practice Location Address
First Line	:	4623 FOREST HILL BLVD
Second Line	:	SUITE 101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-7469
Country	:	US
Telephone Number	:	561-967-8888
Fax Number	:	561-641-8303

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

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	07/09/2007

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