Provider Demographics
NPI:1275682353
Name:FEENEY, MARK J (DC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:J
Last Name:FEENEY
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 1:1700 ALMSHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1002
Mailing Address - Country:US
Mailing Address - Phone:215-343-4036
Mailing Address - Fax:215-343-6247
Practice Address - Street 1:1700 ALMSHOUSE RD
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1002
Practice Address - Country:US
Practice Address - Phone:215-343-4036
Practice Address - Fax:215-343-6247
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007190L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU69900Medicare UPIN
PAFE007752Medicare ID - Type Unspecified