Individual
MARK ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFO COF
Contact information
Practice address
5950 HAMPTON LEAS LN, COLUMBIA, SC 29209-1900
(803) 960-0952
(803) 776-6639
Mailing address
5950 HAMPTON LEAS LN, COLUMBIA, SC 29209-1900
(803) 960-0952
(803) 776-6639
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Enumeration date
01/01/2008
Last updated
01/01/2008
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