Individual
MR. MARK WAGNER TULENKO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MPT OCS CSCS
Contact information
Practice address
1410 INCARNATION DR, ATLANTIC SPORTS AND REHAB STE 101, CHARLOTTESVILLE, VA 22901
(434) 978-4915
(434) 978-7194
Mailing address
1410 INCARNATION DR, ATLANTIC SPORTS AND REHAB STE 101, CHARLOTTESVILLE, VA 22901
(434) 978-4915
(434) 978-7194
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305004631
—
Other
Enumeration date
04/01/2006
Last updated
07/08/2007
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