Provider Demographics
NPI:1891832390
Name:STRUTZ, MARCUS SHELDON (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:SHELDON
Last Name:STRUTZ
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:PO BOX 463
Mailing Address - Street 2:45098 MAIN ST #5
Mailing Address - City:MENDOCINO
Mailing Address - State:CA
Mailing Address - Zip Code:95460-0463
Mailing Address - Country:US
Mailing Address - Phone:707-937-2773
Mailing Address - Fax:
Practice Address - Street 1:45098 MAIN ST #5
Practice Address - Street 2:
Practice Address - City:MENDOCINO
Practice Address - State:CA
Practice Address - Zip Code:95460-0463
Practice Address - Country:US
Practice Address - Phone:707-937-2773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor