Provider Demographics
NPI:1215994793
Name:MARCY SEDONA SERVICES, INC
Entity type:Organization
Organization Name:MARCY SEDONA SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMER
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:MARCY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-567-4846
Mailing Address - Street 1:PO BOX 2580
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-2580
Mailing Address - Country:US
Mailing Address - Phone:928-567-4846
Mailing Address - Fax:928-567-9606
Practice Address - Street 1:348 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-7155
Practice Address - Country:US
Practice Address - Phone:928-567-4846
Practice Address - Fax:928-567-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty