Mark Wade, DC | |
10629 Big Bend Rd Ste 224, Riverview, FL 33579-7176 | |
(813) 590-7799 | |
Not Available |
Full Name | Mark Wade |
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Gender | Male |
Speciality | Chiropractor |
Location | 10629 Big Bend Rd Ste 224, Riverview, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407635196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH14706 (Florida) | Primary |
Provider Name | G Stanford Pierce Dc Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1679675607 PECOS PAC ID: 3072619386 Enrollment ID: O20070503000148 |
Mailing Address | Practice Location Address |
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Mark Wade, DC 225 1st Ave N Unit 2201, St Petersburg, FL 33701-3739 Ph: () - | Mark Wade, DC 10629 Big Bend Rd Ste 224, Riverview, FL 33579-7176 Ph: (813) 590-7799 |
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