Individual
MARK REID WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1711 COLLEGE AVE, JACKSON, AL 36545-2425
(251) 246-5761
(251) 246-5665
Mailing address
PO BOX 37, JACKSON, AL 36545-0037
(251) 246-5761
(251) 246-5665
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH6049
AL
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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