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Individual

MARK BODIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1004 N WALNUT ST, MILFORD, DE 19963-1244
(302) 422-6670
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10001805
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1558389759
DE
01
3502360000
IBC AMERIHEALTH
01
5070-0094
GHMSI
MD
01
64332706
CAREFIRST MD
MD
Enumeration date
07/17/2006
Last updated
03/22/2013
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