Organization
MARK MCDONALD P.T., P.C.
Active
Parent organization
MARK MCDONALD P.T., P.C.
Other names
Mark McDonald Physical Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARK MCDONALD P.T., P.C.
Authorized official
MRS. KATHY E GREEN (ADMINISTRATIVE ASSISTANT)
(970) 522-7743
Entity
Organization
Contact information
Practice address
102 W LARIMER STREET, FLEMING, CO 80725
(970) 265-4878
Mailing address
427 W MAIN ST, STERLING, CO 80751-3033
(970) 522-7743
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P6403
BLUE CROSS
CO
Enumeration date
05/02/2012
Last updated
05/02/2012
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