Individual
MARK ROBERT WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4570 CHURCHILL ST STE 300, SHOREVIEW, MN 55126-2274
(651) 481-1071
(651) 481-0042
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12361
MN
225100000X
Physical Therapist
1990
SD
Other
Enumeration date
05/12/2017
Last updated
10/25/2021
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