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Individual
DR. MARK DYNAN
Active
Individual
DR. MARK DYNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11208
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110094351A
—
MA
Enumeration date
11/02/2010
Last updated
12/18/2012
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