Individual
MARK JOSEPH SURPRENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
20 PLANTATION DR, JAFFREY, NH 03452-6631
(603) 532-8762
Mailing address
37 8TH AVE, LOWELL, MA 01854-1501
(978) 509-8698
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8454
MA
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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