Individual
MR. MARK CHARLES KAHLBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
2093 E WILLOW WICK RD, GILBERT, AZ 85296-2747
(480) 205-6917
(480) 361-4420
Mailing address
2093 E WILLOW WICK RD, GILBERT, AZ 85296-2747
(480) 205-6917
(480) 361-4420
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2559
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2559
AZ STATE OT LICENSE
AZ
Enumeration date
12/08/2006
Last updated
07/08/2007
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