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NPI Code Detail

MEDICARE: DR. MARK D CHANCE

MEDICARE: DR. MARK D CHANCE
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
1111N00000XChiropractorCH6635FL

General Provider Information

NPI Number : 1952355760
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK D CHANCE
Provider Business Mailing Address
First Line : 1240 NW 11TH AVE
Second Line :
City : GAINESVILLE
State : FL
Zip : 32601-4146
Country : US
Telephone Number : 352-375-6972
Fax Number :
Provider Business Practice Location Address
First Line : 1240 NW 11TH AVE
Second Line :
City : GAINESVILLE
State : FL
Zip : 32601-4146
Country : US
Telephone Number : 352-375-6972
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 01/30/2012

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Directions to “ DR. MARK D CHANCE ” Practice Location

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