Provider Demographics
NPI:1023196144
Name:SCARANO, MARK VINCENT (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:VINCENT
Last Name:SCARANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W RAHN ROAD
Mailing Address - Street 2:28
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429
Mailing Address - Country:US
Mailing Address - Phone:937-294-2828
Mailing Address - Fax:937-434-7603
Practice Address - Street 1:30 W RAHN ROAD
Practice Address - Street 2:28
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429
Practice Address - Country:US
Practice Address - Phone:937-294-2828
Practice Address - Fax:937-434-7607
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor