Provider Demographics
NPI:1710047501
Name:SCHWARTZ, MARC (DC,CCN,CCSP)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DC,CCN,CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 ORTHODOX DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1140
Mailing Address - Country:US
Mailing Address - Phone:215-953-1276
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD
Practice Address - Street 2:SIUTE 435
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3706
Practice Address - Country:US
Practice Address - Phone:215-881-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3631111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NN1001XChiropractic ProvidersChiropractorNutrition
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2457877000OtherBCBS NUMBER
PA2457877000OtherBCBS NUMBER