Provider Demographics
NPI:1447244595
Name:YECK, MARC WARREN (DC)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:WARREN
Last Name:YECK
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 1:5965 E LUDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2447
Mailing Address - Country:US
Mailing Address - Phone:231-843-1874
Mailing Address - Fax:231-845-9928
Practice Address - Street 1:5965 E LUDINGTON AVE
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2447
Practice Address - Country:US
Practice Address - Phone:231-843-1874
Practice Address - Fax:231-845-9928
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
950E350320OtherBC
T97189Medicare UPIN
950E350320OtherBC