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Mark Jicov Ghali

Student in an Organized Health Care Education/Training Program

Student, Health Care

270 Copperfield Blvd NE Ste 202, Concord, NC 28025-2441

(704) 721-2060

PECOS Enrollment

Based on the most recent information from CMS, provider Mark Jicov Ghali does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:51 AM.

Profile Details

Provider ID
1730424268
Provider Type
Individual
Full Name
Ghali, Mark Jicov
Title
Dr.
Credential
D.C.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
12/10/2012
Last Updated
3/24/2025

Contact Information

Practice Location

270 Copperfield Blvd NE Ste 202, Concord, NC 28025-2441

(704) 721-2060

Unlisted Fax

Mailing Location

270 Copperfield Blvd NE Ste 202, Concord, NC 28025-2441

(704) 721-2060

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer
Code 111N00000X	Description Chiropractor Chiropractic Providers	License CHIR009029 Georgia
Code 111N00000X	Description Chiropractor Chiropractic Providers	License CH11793 Florida

Mark Jicov Ghali

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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