Individual
MARK POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
6400 FREMONT RD, EAST SYRACUSE MINOA HS, EAST SYRACUSE, NY 13057-9436
(315) 434-3300
(315) 434-3360
Mailing address
6400 FREMONT RD, EAST SYRACUSE MINOA HS, EAST SYRACUSE, NY 13057-9436
(315) 434-3300
(315) 434-3360
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000352-1
NY
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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