Provider Demographics
NPI:1225098502
Name:BATEMAN, MARK ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ALLEN
Last Name:BATEMAN
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 1:4608 ROUTE 309
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078
Mailing Address - Country:US
Mailing Address - Phone:610-799-2242
Mailing Address - Fax:610-799-2243
Practice Address - Street 1:4608 ROUTE 309
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078
Practice Address - Country:US
Practice Address - Phone:610-799-2242
Practice Address - Fax:610-799-2243
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002308L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
185323Medicare ID - Type Unspecified
T30008Medicare UPIN