Individual
MARK WINN TADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
701 WEST WETMORE RD. RM. 168, AMPHITHEATER PUBLIC SCHOOLS, TUCSON, AZ 85705-1547
(520) 696-5237
(520) 696-5067
Mailing address
701 WEST WETMORE RD. RM. 168, PIMA COUNTY AMPHITHEATER SCHOOLS, TUCSON, AZ 85705-1547
(520) 696-5237
(520) 696-5067
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1829
AZ
225X00000X
Occupational Therapist
1829
AZ
Other
Enumeration date
03/05/2008
Last updated
10/01/2008
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