Individual
MARK K GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
516 ROYAL ST, NATCHITOCHES, LA 71457-5713
(318) 289-8806
Mailing address
516 ROYAL ST, NATCHITOCHES, LA 71457-5713
(318) 289-8806
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11531
LA
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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