Provider Demographics
NPI:1295812279
Name:SCHWEITZER, MARK GREG (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:GREG
Last Name:SCHWEITZER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20 N GRAND AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1755
Mailing Address - Country:US
Mailing Address - Phone:859-441-8800
Mailing Address - Fax:859-441-8813
Practice Address - Street 1:20 N GRAND AVE STE 12
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1755
Practice Address - Country:US
Practice Address - Phone:859-441-8800
Practice Address - Fax:859-441-8813
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 4150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6106101Medicare PIN