Individual
MARK WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
543 CALISTOGA RD, SANTA ROSA, CA 95409-3708
(707) 479-4680
Mailing address
543 CALISTOGA RD, SANTA ROSA, CA 95409-3708
(707) 479-4680
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4231
CA
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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