Provider Demographics
NPI:1467638478
Name:MARK L. SCHWARTZ, DC PC
Entity Type:Organization
Organization Name:MARK L. SCHWARTZ, DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-332-1006
Mailing Address - Street 1:4550 EUBANK BLVD NE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3479
Mailing Address - Country:US
Mailing Address - Phone:505-332-1006
Mailing Address - Fax:505-332-0400
Practice Address - Street 1:4550 EUBANK BLVD NE
Practice Address - Street 2:SUITE 107
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3479
Practice Address - Country:US
Practice Address - Phone:505-332-1006
Practice Address - Fax:505-332-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty