Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH0004473 | FL |
NPI | 1598816159 |
---|---|
Provider Name | Dr. Martin Philip Marcus |
First Address | St Petersburg, FL 33707-1119 |
Second Address | St Petersburg, FL 33707-1119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 08/07/2007 |