DR. Mark Eavenson, DC

NPI #1629037536 in Granite City, Illinois

Provider Information

NPI Number: 1629037536
Entity Type: Individual
Name: DR. Mark Eavenson, DC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Credential: DC
Enumeration Date: Mar 20, 2006
Last Updated: Jul 19, 2007

Practice Location

Address: 3986 MARYVILLE RD
City: Granite City
State: Illinois
ZIP Code: 62040-4191
Phone: (618) 797-0618

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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