Mark Eavenson is a Chiropractor in Granite City, Illinois. Mark Eavenson practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Mark Eavenson is 1629037536. The last update date is 2007-07-19.
Mark Eavenson's current location address is 3986 Maryville Rd, Granite City, Illinois. You can contact this provider via phone number 6187970618 and fax number 6187972243. The mailing address for Mark Eavenson is 3986 Maryville Rd, Granite City, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Eavenson |
|---|---|
| Address | 3986 Maryville Rd, Granite City, Illinois |
| Phone Number | 6187970618 |
| Fax Number | 6187972243 |
| Sole Proprietor | N |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1629037536 |
|---|---|
| Provider Enumeration Date | 2006-03-20 |
| Last Updated Date | 2007-07-19 |
Provider Mailing Address Detail
| Address | 3986 Maryville Rd |
|---|---|
| City | Granite City |
| State | Illinois (IL) |
| Post Code | 620404191 |
| Phone Number | 6187970618 |
| Fax Number | 6187972243 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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What is the Mark Eavenson's unique identification number?
The Mark Eavenson has been assigned the NPI (National Provider Identifier) Number 1629037536 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Mark Eavenson located?
The Mark Eavenson is located at 3986 Maryville Rd, Granite City, IL 620404191.
What is Mark Eavenson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mark Eavenson's area of specialization is Chiropractor, and the corresponding taxonomy code that categorizes this field of practice is 111N00000X.
On what date did the Mark Eavenson receive its 1629037536 assignment from the Centers for Medicare & Medicaid Services?
The Mark Eavenson was assigned its 1629037536 by the Centers for Medicare & Medicaid Services on 2006-03-20.
When was the Mark Eavenson's information last updated?
The Mark Eavenson's information was last updated on 2007-07-19.
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