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Individual

MARK CARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
229 4TH AVENUE, NORMANDY BEACH, NJ 08739-0229
(973) 951-6287
Mailing address
PO BOX 229, NORMANDY BEACH, NJ 08739-0229
(973) 951-6287

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C06845216305494
NJ

Other

Enumeration date
09/13/2019
Last updated
09/13/2019
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