Individual
BETH MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3040 N 400 E, LEBANON, IN 46052-9276
(317) 442-8253
Mailing address
3040 N 400 E, LEBANON, IN 46052-9276
(317) 442-8253
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002635A
IN
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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