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Individual

DR. MARK DYNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT, OCS

Contact information

Practice address
16 HAYDEN AVENUE, LAHEY LEXINGTON, LEXINGTON, MA 02421-7929
(781) 372-7060
(781) 372-7069
Mailing address
16 HAYDEN AVENUE, LAHEY LEXINGTON, LEXINGTON, MA 02421-7929
(781) 372-7060

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11208
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110094351A
MA
Enumeration date
11/02/2010
Last updated
12/18/2012
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