Individual
MR. MARK PERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5515 GLEN LAKES DR, DALLAS, TX 75231-4309
(214) 361-8923
Mailing address
90 DUNCAN DR, JACKSON, TN 38305-1509
(731) 298-1848
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
5022
TN
314000000X
Skilled Nursing Facility
Primary
5022
TX
Other
Enumeration date
02/19/2012
Last updated
02/19/2012
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