Individual
MARK D MYLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CST/CFA
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6000
Mailing address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6000
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
91004
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
91004
STATE CERTIFICATION NUMBER
WI
Enumeration date
06/24/2008
Last updated
06/24/2008
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