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Individual
MARK MCLEOD
Active
Individual
MARK MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60378305
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992139612
—
WA
01
—
P01361142
RR MEDICARE
WA
Enumeration date
08/29/2013
Last updated
10/30/2014
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