# MARK H KILLIAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1831208693
- **Gender:** Man
- **Credential:** P.T., L.A.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 4902-024 | WI | Yes |
| 2255A2300X | Athletic Trainer | 38-039 | WI | — |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 12/04/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 40286100 | — | WI |