Provider Demographics
NPI:1710041926
Name:NATHAN, MARK BARRINGTON (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:BARRINGTON
Last Name:NATHAN
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 1:601 NW 42ND AVE
Mailing Address - Street 2:#210
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2119
Mailing Address - Country:US
Mailing Address - Phone:786-213-3433
Mailing Address - Fax:
Practice Address - Street 1:1730 NW 122ND TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-1967
Practice Address - Country:US
Practice Address - Phone:954-432-8910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor