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Individual

MR. MARK FORNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
125 W 16TH ST, #117, NEW YORK CITY, NY 10011
(212) 741-9660
(212) 741-9660
Mailing address
190 NORTH LONG BEACH AVE, FREEPORT, NY 11520
(516) 623-4397

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X0041411
NY

Other

Enumeration date
04/03/2007
Last updated
07/08/2007
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