Individual
MARK LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 FOREST AVE, ZANESVILLE, OH 43701-2882
(617) 413-6672
Mailing address
800 FOREST AVE, ZANESVILLE, OH 43701-2882
(617) 413-6672
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/17/2011
Last updated
11/15/2011
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