Individual
MARK ZACHARY MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1114 W JACKSON ST, OZARK, MO 65721-9164
(417) 581-1234
(888) 550-3518
Mailing address
1114 W JACKSON ST, OZARK, MO 65721-9164
(417) 581-1234
(888) 550-3518
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2008022379
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA4370001
MEDICARE PTAN
MO
Enumeration date
09/26/2012
Last updated
12/29/2015
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