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Individual

MR. MARK DUANE ASHBAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
126 MISSOURI AVENUE, FT LEONARD WOOD, MO 65473
(573) 596-0048
Mailing address
28665 HIGHWAY AB, RICHLAND, MO 65556-7463
(757) 525-0501

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary

Other

Enumeration date
09/08/2010
Last updated
09/08/2010
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