Individual
MARK JOSEPH WHEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
449 RIVER RD APT 5, WINDHAM, ME 04062-4279
(207) 240-5769
Mailing address
449 RIVER RD APT 5, WINDHAM, ME 04062-4279
(207) 240-5769
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
0928
NH
225200000X
Physical Therapy Assistant
Primary
PA2516
ME
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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