Provider Demographics
NPI:1386866655
Name:METZNER, MARK A (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:METZNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14619 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1723
Mailing Address - Country:US
Mailing Address - Phone:562-693-4434
Mailing Address - Fax:562-693-1239
Practice Address - Street 1:14619 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1723
Practice Address - Country:US
Practice Address - Phone:562-693-4434
Practice Address - Fax:562-693-1239
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor