Individual
MR. MARK RAYMOND WESTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1610 JOHN ORR DR, TIFTON, GA 31794-3682
(229) 391-4580
(229) 391-4585
Mailing address
604 US HIGHWAY 19 N, AMERICUS, GA 31719-8300
(229) 938-8072
(229) 391-4585
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2118
GA
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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