Individual
MARK ALAN TUDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1650 LEE LN, BELOIT, WI 53511-3935
(608) 365-8660
(608) 365-6342
Mailing address
2223 ALONGI LN, STE M, BELOIT, WI 53511-2393
(608) 365-8660
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
334-039
WI
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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