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Individual
MR. MARK ELLIOT WURSTER
Active
Individual
MR. MARK ELLIOT WURSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7136
MA
225100000X
Physical Therapist
822
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000Y66669
BLUE CROSS OF MA
MA
01
—
050504796
UNITED HEALTHCARE
RI
01
—
402345
BLUE CHIP
RI
01
—
7857-1
BLUE CROSS
RI
Enumeration date
09/28/2006
Last updated
06/21/2018
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