Provider Demographics
NPI:1235415340
Name:KERSCHNER, MARC JAY (DC,)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:JAY
Last Name:KERSCHNER
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 1:1803 BARNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6146
Mailing Address - Country:US
Mailing Address - Phone:561-596-3735
Mailing Address - Fax:
Practice Address - Street 1:1803 BARNSTABLE RD
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6146
Practice Address - Country:US
Practice Address - Phone:561-596-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor