Individual
DR. SAMUEL B MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
218 W 27TH ST, SCOTTSBLUFF, NE 69361-4306
(308) 633-2200
Mailing address
218 W 27TH ST, SCOTTSBLUFF, NE 69361-4306
(308) 633-2200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1333
NE
171100000X
Acupuncturist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99671
BLUE CROSS BLUE SHIELD
NE
Enumeration date
10/16/2006
Last updated
04/19/2021
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