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Dr. Glen Robert Mark, DC
Chiropractor in Riverhead, New York
NPI 1669415238

Glen Robert Mark is a Chiropractor based in Riverhead, NY. Glen Robert Mark practices in Riverhead, NY and has the professional credentials of DC. The NPI Number for Glen Robert Mark is 1669415238 and holds a License No. XOO7337-1 (New York).

The current practice location address for Glen Robert Mark is 633 Roanoke Ave, Riverhead, NY and can be reached out via phone at 631-727-3795 and via fax at 631-727-1961.

Location: 633 Roanoke Ave, Riverhead, NY, 11901-2789
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669415238
Provider Name
Glen Robert Mark
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
633 Roanoke Ave, Riverhead, NY, 11901-2789
Phone Number
631-727-3795
Fax Number
631-727-1961
Provider Enumeration Date
06/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CO-7337-1 01 NY WORKERS COMPENSATION
institution
Provider Business Practice Location Address Details
Address
633 Roanoke Ave
City
Riverhead
State
New York
Zip
11901-2727
Phone Number
631-727-3795
Fax Number
631-727-1961
person
Provider Business Mailing Address Details
Address
633 Roanoke Ave
City
Riverhead
State
New York
Zip
11901-2727
Phone Number
631-727-3795
Fax Number
631-727-1961
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
XOO7337-1 (New York)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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