Individual
MARK S. POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
872 W DAYTON ST, GALESBURG, IL 61401-1503
(309) 344-3400
(309) 344-5040
Mailing address
872 W DAYTON ST, GALESBURG, IL 61401-1503
(309) 344-3400
(309) 344-5040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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