Individual
MARK NILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1720 PEACHTREE ST NW, SUIT 422, ATLANTA, GA 30309-2449
(404) 733-1936
Mailing address
1720 PEACHTREE ST NW, SUIT 422, ATLANTA, GA 30309-2449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008691
GA
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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