Individual
MARK WILLIAM LONGALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2420 W 82ND PL, UNIT D, WESTMINSTER, CO 80031-4010
(303) 907-7086
Mailing address
2420 W 82ND PL, UNIT D, WESTMINSTER, CO 80031-4010
(303) 907-7086
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
200394
CO
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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