Individual
MR. MARK G STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5150 STILESBORO RD NW, KENNESAW, GA 30152-7744
(678) 354-6171
Mailing address
5639 WANDERING VINE LN SE, MABLETON, GA 30126-5637
(757) 927-2851
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008764
GA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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