MEDICARE: DR. MARK S SANEMAN 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	7883	TX

General Provider Information

NPI Number	:	1710034772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK S SANEMAN D.C.

Provider Business Mailing Address
First Line	:	637 CREEKVIEW DR
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-4445
Country	:	US
Telephone Number	:	817-966-8772
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 SYCAMORE SCHOOL RD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76134-5008
Country	:	US
Telephone Number	:	817-615-8200
Fax Number	:	817-615-8203

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. MARK S SANEMAN D.C.” Practice Location

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