Provider Demographics
NPI:1588855720
Name:MARK D WARNER DC PLLC
Entity Type:Organization
Organization Name:MARK D WARNER DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC PLLC
Authorized Official - Phone:419-726-1352
Mailing Address - Street 1:4554 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43611-2808
Mailing Address - Country:US
Mailing Address - Phone:419-726-1352
Mailing Address - Fax:734-726-5613
Practice Address - Street 1:4554 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-2808
Practice Address - Country:US
Practice Address - Phone:419-726-1352
Practice Address - Fax:734-726-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ON72900Medicare PIN
U99548Medicare UPIN