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Individual
MARK ANDREW CARLSON
Active
Individual
MARK ANDREW CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NMD, HHP, CMT, MST
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
18590
CA
Other
Enumeration date
11/19/2016
Last updated
11/19/2016
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