Provider Demographics
NPI:1326042755
Name:LANEY, JOHN MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:LANEY
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 1:213 CAPITOL ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-6232
Mailing Address - Country:US
Mailing Address - Phone:207-623-4222
Mailing Address - Fax:207-623-2343
Practice Address - Street 1:213 CAPITOL ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6232
Practice Address - Country:US
Practice Address - Phone:207-623-4222
Practice Address - Fax:207-623-2343
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR 720111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor