Individual
MR. MARK DAVID LEGACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, ATC
Contact information
Practice address
17 HIGH ST # 32 MSC #, PE CENTER PLYMOUTH STATE UNIVERSITY, PLYMOUTH, NH 03264-1595
(603) 535-2757
Mailing address
17 HIGH ST # 32 MSC #, PE CENTER PLYMOUTH STATE UNIVERSITY, PLYMOUTH, NH 03264-1595
(603) 535-2757
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0003
NH
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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