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Individual

MARK OLIVER MAGNO CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTR

Contact information

Practice address
6685 E 117TH AVE, CROWN POINT, IN 46307-7808
(219) 663-6392
Mailing address
6685 E 117TH AVE, CROWN POINT, IN 46307-7808
(219) 663-6392

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008235A
IN

Other

Enumeration date
08/27/2010
Last updated
08/27/2010
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