Provider Demographics
NPI:1952301152
Name:DAY, MARK OLIVER SR (DC, CSCS, DACBSP)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:OLIVER
Last Name:DAY
Suffix:SR
Gender:M
Credentials:DC, CSCS, DACBSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-1271
Mailing Address - Country:US
Mailing Address - Phone:606-564-6831
Mailing Address - Fax:606-564-8300
Practice Address - Street 1:151 E 3RD ST
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-1271
Practice Address - Country:US
Practice Address - Phone:606-564-6831
Practice Address - Fax:606-564-8300
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1787111NS0005X
KY249851111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
311345271OtherTAX ID OTHER INS. NUMBER
KY85001352Medicaid
OH0868717Medicaid
KY000000016455OtherANTHEM PROVIDER NUMBER
OH000000016455OtherANTHEM PROVIDER NUMBER
KY000000016455OtherANTHEM PROVIDER NUMBER
OHDAO712561Medicare ID - Type Unspecified
OH0868717Medicaid