Provider Demographics
NPI:1073515102
Name:SARACINO, MARK ANTHONY (DC DACAN)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANTHONY
Last Name:SARACINO
Suffix:
Gender:M
Credentials:DC DACAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1150 1ST AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1334
Mailing Address - Country:US
Mailing Address - Phone:610-337-3335
Mailing Address - Fax:610-337-4858
Practice Address - Street 1:1150 1ST AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1334
Practice Address - Country:US
Practice Address - Phone:610-337-3335
Practice Address - Fax:610-337-4858
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038 004717111NN0400X
PA002534 L111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology