Individual
MARK GOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L CHT
Contact information
Practice address
104 B NORTH 21ST STREET, PHILADELPHIA, PA 19103
(267) 474-1879
Mailing address
104 B NORTH 21ST STREET, PHILADELPHIA, PA 19103
(267) 474-1879
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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