Individual
MARK JAMES PENDERGAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
245 PEACHTREE IND BLVD #100, SUWANEE, GA 30022
(678) 541-0777
Mailing address
10945 STATE BRDG RD #401-294, ALPHARETTA, GA 30022
(678) 541-0777
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO07830
GA
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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