Provider Demographics
NPI:1578625877
Name:NANCE, MARK ANDERSON (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDERSON
Last Name:NANCE
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 1:169 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-8409
Mailing Address - Country:US
Mailing Address - Phone:828-645-2526
Mailing Address - Fax:828-645-2521
Practice Address - Street 1:169 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-8409
Practice Address - Country:US
Practice Address - Phone:828-645-2526
Practice Address - Fax:828-645-2521
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1762111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC330678OtherCIGNA HEALTHCARE
NC330678OtherUNITED HEALTH CARE
NC8908981Medicaid
NC08981OtherNC BLUE CROSS BLUE SHIELS
NC08686OtherMEDCOST
NC08686OtherHEALTHCARE SAVINGS
NC08686OtherCNC
NC8908981Medicaid
NC08686OtherMEDCOST