Provider Demographics
NPI:1457578882
Name:SOMMER, MARC (DC)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:SOMMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:MARC
Other - Middle Name:
Other - Last Name:SOMMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:230 PASSAIC AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-3505
Mailing Address - Country:US
Mailing Address - Phone:973-838-2106
Mailing Address - Fax:973-838-2572
Practice Address - Street 1:230 PASSAIC AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-3505
Practice Address - Country:US
Practice Address - Phone:973-838-2106
Practice Address - Fax:973-838-2572
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC1704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor