Individual
MARK WILLIAM WORRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13643 HATTERAS ST, VAN NUYS, CA 91401-4519
(818) 997-7635
Mailing address
13643 HATTERAS ST, VAN NUYS, CA 91401-4519
(818) 997-7635
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10897
CA
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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