Individual
MR. MARK SIPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
301 ADOBE CANYON RD, KENWOOD, CA 95452-9047
(707) 362-0743
Mailing address
301 ADOBE CANYON RD, KENWOOD, CA 95452-9047
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT5766
CA
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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