Provider Demographics
NPI:1821083668
Name:MARKLEY, GUY JR (DC)
Entity Type:Individual
Prefix:MR
First Name:GUY
Middle Name:
Last Name:MARKLEY
Suffix:JR
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 1:1802 W BAKER ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-2912
Mailing Address - Country:US
Mailing Address - Phone:813-752-6001
Mailing Address - Fax:813-754-3162
Practice Address - Street 1:1802 W BAKER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-2912
Practice Address - Country:US
Practice Address - Phone:813-752-6001
Practice Address - Fax:813-754-3162
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55904Medicare UPIN
FL88624Medicare PIN