Individual
MR. MARK A PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA-01827
Contact information
Practice address
1170 W MANSFIELD ST, BUCYRUS, OH 44820-8509
(419) 562-9907
(419) 562-1962
Mailing address
1138 KELLER DR, MANSFIELD, OH 44905-1635
(419) 632-9744
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-01827
OH
Other
Enumeration date
07/23/2007
Last updated
07/07/2008
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