Individual
MARIO CARRASCO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 W 15TH ST, MONAHANS, TX 79756-8301
(888) 873-4221
Mailing address
1541 E 51ST ST, ODESSA, TX 79762-4440
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2067933
TX
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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